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Research Studies is a compilation of published research articles funded by 大象视频or authored by 大象视频researchers.

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1 to 6 of 6 Research Studies Displayed
Bradley K, McCormack J, Addis M
Do electronic health records used by primary care practices support recommended alcohol-related care?
In a multi-state sample of 167 primary care practices, electronic health records (EHRs) demonstrated limited functionality for alcohol-related prevention and treatment. Fewer than two-thirds of EHRs provided a validated screening questionnaire or automatically scored screening results, and only a small portion could document or report brief interventions. For alcohol use disorders, slightly under half tracked diagnostic information and a minority supported referrals or monitored medication use. Experts from regional improvement initiatives had identified these features as crucial for promoting evidence-based care.
AHRQ-funded; HS027078; HS027088; HS027077; HS027076; HS027080.
Citation: Bradley K, McCormack J, Addis M . Do electronic health records used by primary care practices support recommended alcohol-related care? JAMIA Open 2024 Dec 4; 7(4):ooae125. doi: 10.1093/jamiaopen/ooae125..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Alcohol Use
Davis MM, Coury J, Sanchez V
Improving screening, brief intervention and referral to treatment for unhealthy alcohol use in diverse, low-resourced primary care clinics.
This paper discusses the results of the ANTECEDENT (Partnerships to Enhance Alcohol Screening, Treatment, and Intervention) practice-facilitator implementation study, whose goal was to increase screening brief intervention and referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) use in diverse primary care clinics. From November 2019 to April 2023, the authors conducted a convergent parallel mixed methods evaluation using participants from small- to medium-sized primary care clinics in Northwestern U.S. Clinics received foundational support (i.e., baseline/exit assessment, access to SBIRT Oregon website) and the option for supplemental implementation support (e.g., practice facilitation, expert consultation) over the 15-month intervention period. They recruited 75 unique clinics; 66 participated and 48 (73%) completed the study. Eight participating clinics chose to receive foundational support only while 58 chose to engage in supplemental support activities. The forty-two clinics that received supplemental support and completed the intervention engaged in practice facilitation, data review (38%), HIT support (31%), expert consultation (19%), and peer-to-peer learning (5%). There was significant improvement shown in self-reported SBIRT process outcomes. Positive experiences were described by clinics with ANTECEDENT support and highlighted remaining barriers to SBIRT and MAUD implementation.
AHRQ-funded; HS027080.
Citation: Davis MM, Coury J, Sanchez V . Improving screening, brief intervention and referral to treatment for unhealthy alcohol use in diverse, low-resourced primary care clinics. BMC Health Serv Res 2024 Nov 12; 24(1):1384. doi: 10.1186/s12913-024-11870-8.
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Screening, Primary Care
Jortberg BT, Dickinson LM, Fernald DH
Improving care for unhealthy alcohol use: results from the Facilitating Alcohol Screening and Treatment (FAST) Colorado Study.
Researchers investigated the effectiveness of virtual practice facilitation of screening, brief intervention, medication-assisted treatment (MAT), or referral for treatment (SBI/RT + MAT) for unhealthy alcohol use and examined the potential added benefits of alcohol use eLearning modules in primary care practices in Colorado. The results provided initial evidence for the successful use of virtual practice facilitation.
AHRQ-funded; HS027079.
Citation: Jortberg BT, Dickinson LM, Fernald DH . Improving care for unhealthy alcohol use: results from the Facilitating Alcohol Screening and Treatment (FAST) Colorado Study. J Am Board Fam Med 2024 Nov-Dec; 37(6):1027-37. doi: 10.3122/jabfm.2024.240048R1..
Keywords: Alcohol Use, Substance Abuse, Screening, Behavioral Health, Primary Care, Quality Improvement, Quality of Care
Huffstetler AN, Villalobos G, Webel B
Practice facilitation to address unhealthy alcohol use in primary care: a cluster randomized clinical trial.
This randomized trial was conducted to determine if practice facilitation improved delivery of the recommended care for unhealthy alcohol use (UAU) compared to usual care. The U.S. Preventive Services Task Force recommends that primary care clinicians routinely screen all adults 18 years and older for UAU. These practices received immediate (intervention), or 6-month delayed (control) practice facilitation, which included tailored educational sessions, workflow management, and tools for addressing UAU. Of the 76 primary care practices enrolled, 32 were randomized to intervention and 35 to control. From baseline to 6 months after intervention, screening with a validated instrument increased from 2.1% to 35.5% in the intervention group compared to 0.4% to 1.4% in the control group. Brief office-based interventions for the intervention group increased from 26.2% to 62.6% vs 45.5% to 55.1% in the control group. Both groups had similar changes for identification of UAU, referral for counseling, and medication treatment. Primary care clinicians felt much more competence and confidence with screening and brief intervention than before the practice facilitation intervention.
AHRQ-funded; HS027077.
Citation: Huffstetler AN, Villalobos G, Webel B . Practice facilitation to address unhealthy alcohol use in primary care: a cluster randomized clinical trial. JAMA Health Forum 2024 Aug 2; 5(8):e242371. doi: 10.1001/jamahealthforum.2024.2371..
Keywords: Primary Care, Practice Improvement, Alcohol Use
Rockwell MS, Funk AJ, Huffstetler AN
Screening for unhealthy alcohol use among patients with multiple chronic conditions in primary care.
This study investigated the impact of multiple chronic conditions on screening for unhealthy alcohol use in primary care. Analyzing electronic health records from 67 Virginia practices (2020-2023), the results showed that 58% of 11,789 patients had multiple chronic conditions. While 69% were screened for alcohol use, only 16% used a U.S. Preventive Services Task Force-recommended instrument. Patients with physical and mental health conditions were less likely to receive screening, despite being more likely to screen positive for unhealthy alcohol use. The findings highlight the need for improved alcohol-related preventive services in primary care, especially for patients with complex health issues.
AHRQ-funded; HS027077.
Citation: Rockwell MS, Funk AJ, Huffstetler AN . Screening for unhealthy alcohol use among patients with multiple chronic conditions in primary care. AJPM Focus 2024 Aug; 3(4):100233. doi: 10.1016/j.focus.2024.100233..
Keywords: Screening, Alcohol Use, Chronic Conditions, Primary Care, Substance Abuse, Behavioral Health, U.S. Preventive Services Task Force (USPSTF)
Bernstein EY, Bernstein TP, Trivedi S
Outcomes after initiation of medications for alcohol use disorder at hospital discharge.
This study looked at outcomes after initiation of medications for alcohol use disorder (MAUD), which are very underutilized. The primary outcome was a composite of all-cause mortality or return to hospital within 30 days of discharge. Secondary outcomes included the previous components separately, return to hospital for alcohol-related diagnoses, and primary care or mental health follow-up within 30 days of discharge. There were 6794 unique individuals representing 9834 alcohol-related hospitalizations (median [IQR] age, 54 years; 3205 hospitalizations among females [32.6%]; 1754 hospitalizations among Black [17.8%], 712 hospitalizations among Hispanic [7.2%], and 7060 hospitalizations among White [71.8%] patients). Of these, 2% of hospitalizations involved discharged MAUD initiation. Discharge MAUD initiation was associated with a 42% decreased incidence of the primary outcome (incident rate ratio, 0.58). These findings were consistent among secondary outcomes (eg, incident rate ratio for all-cause return to hospital, 0.56) except for mortality, which was rare in both groups. Discharge MAUD initiation was associated with a 51% decreased incidence of alcohol-related return to hospital.
AHRQ-funded; HS026215.
Citation: Bernstein EY, Bernstein TP, Trivedi S . Outcomes after initiation of medications for alcohol use disorder at hospital discharge. JAMA Netw Open 2024 Mar 4; 7(3):e243387. doi: 10.1001/jamanetworkopen.2024.3387..
Keywords: Medication, Alcohol Use, Substance Abuse, Behavioral Health, Outcomes, Hospital Discharge

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