Implementation and Quality Improvement of a Screening and Counseling Program for Unhealthy Alcohol Use in an Academic General Internal Medicine Practice
Open accessAbstract
Unhealthy alcohol use is the third leading cause of preventable death in the United States. The U.S. Preventive Services Task Force (USPSTF) recommends screening for unhealthy alcohol use but little is known about how best to do so. We used quality improvement techniques to implement a systematic approach to screening and counseling primary care patients for unhealthy alcohol use. Components included use of validated screening and assessment instruments; an evidence-based two-visit counseling intervention using motivational interviewing techniques for those with risky drinking behaviors who did not have an alcohol use disorder (AUD); shared decision making about treatment options for those with an AUD; support materials for providers and patients; and training in motivational interviewing for faculty and residents. Over the course of one year, we screened 52% (N= 5,352) of our clinic's patients and identified 294 with positive screens. Of those 294, appropriate screening-related assessments and interventions were documented for 168 and 72 patients, respectively. Although we successfully implemented a systematic screening program and structured processes of care, ongoing quality improvement efforts are needed to screen the rest of our patients and to improve the consistency with which we provide and document appropriate interventions.
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- Authors
- Jonas, D. E., Miller, T., Ratner, S., McGuirt, B., Golin, C. E., Grodensky, C., Sturkie, E., Kinley, J., Dale, M., & Pignone, M.
- Affiliations
- Society of General Internal Medicine (US)
- Venue
- Journal for Healthcare Quality
- Published
- 2017-01
- Volume
- 39
- Issue
- 1
- Pages
- 15-27
- ISSN
- 1062-2551 (ISSN-L)
- 1945-1474
- PMC
- PMC5213337
- OpenAlex
- W2565436857
- Cited by
- 16
- References
- 29
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 1 · 2022: 1 · 2021: 5 · 2020: 1 · 2018: 3 · 2017: 1 · 2016: 1
- FWCI
- 1.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal for Healthcare Quality (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- National Institutes of Health (AI50410)
- Center for AIDS Research, University of Washington (P30 AI-50410, AI50410)
- University of North Carolina at Chapel Hill (P30AI50410)
- National Institute of Allergy and Infectious Diseases (P30AI050410)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- unhealthy alcohol use, alcohol screening, motivational interviewing, alcoholism, shared decision-making, primary care, general internal medicine, quality improvement, alcoholism treatment, provider training
- MeSH terms
- Adult, Aged, Aged, 80 and over, Alcohol Drinking, Counseling, Delivery of Health Care, Female, Humans, Male, Mass Screening, Middle Aged, North Carolina, Patient Education as Topic, Primary Health Care, Quality Improvement
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