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Research Studies is a compilation of published research articles funded by ´óÏóÊÓƵor authored by ´óÏóÊÓƵresearchers.

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1 to 25 of 71 Research Studies Displayed
Hamilton LK, Lapham GT, Day A
Improving alcohol-related care in small-medium primary care practices: an evaluation of an adaptation of the SPARC trial intervention for small-medium sized practices.
The Michigan Sustained Patient-centered Alcohol-Related Care (MI-SPARC) study tested an adaptation of the original SPARC trial to increase identification and treatment of unhealthy alcohol use. Results showed that, despite adaptions for smaller primary care practices and screening improvements, MI-SPARC did not increase brief intervention and AUD medication treatment. The researchers concluded that this reflected a mismatch between intervention complexity and implementation infrastructure in primary care practices.
AHRQ-funded; HS027076.
Citation: Hamilton LK, Lapham GT, Day A . Improving alcohol-related care in small-medium primary care practices: an evaluation of an adaptation of the SPARC trial intervention for small-medium sized practices. J Subst Use Addict Treat 2025 Jun; 173:209697. doi: 10.1016/j.josat.2025.209697..
Keywords: Alcohol Use, Primary Care, Patient-Centered Healthcare
Bishop D, Parsons D, Villalobos G
Reducing stigma through conversations in primary care about unhealthy alcohol use.
To improve how primary care teams talk with patients about alcohol use, this study implemented an ´óÏóÊÓƵEvidenceNOW strategy that used practice facilitators to support respectful, nonjudgmental communication. Clinics adopted standard language and workflows to normalize screening and reduce stigma. Materials emphasized that alcohol screening is routine and not targeted, helping patients feel less judged. Findings suggest that even small changes in language and approach can significantly enhance trust and uptake of alcohol-related health interventions.
AHRQ-funded.
Citation: Bishop D, Parsons D, Villalobos G . Reducing stigma through conversations in primary care about unhealthy alcohol use. Ann Fam Med 2025 Jan 27; 23(1):83. doi: 10.1370/afm.240384..
Keywords: Alcohol Use, Substance Abuse, Social Stigma, Primary Care, Communication, Clinician-Patient Communication, Behavioral Health
Kenzie ES, Weekley T, Barnes C
Co-created improvement goals and strategies for implementing SBIRT and MAUD in primary care settings in a facilitator-supported, tailored implementation study.
This study’s goal was to create improvement goals and and strategies for implementing screening, brief intervention, and referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) in primary care settings in a facilitator-supported, tailored implementation study. The authors used practice facilitation to support the implementation of SBIRT and MAUD in 48 clinical practices across Oregon, Washington, and Idaho. They used clinic contact logs, individual interviews, group periodic reflections with practice facilitators, and exit interviews with clinic staff to inform qualitative analysis. Clinics identified goals spanning SBIRT, MAUD, reporting, targeted patient outreach, and quality improvement capacity. Goals addressed both the technical (e.g., data tracking) and social (e.g. staff training) aspects of SBIRT and MAUD. A decision tree was also created that summarized emergent findings into a tool to support future implementation of SBIRT in primary care settings.
AHRQ-funded; HS027080.
Citation: Kenzie ES, Weekley T, Barnes C . Co-created improvement goals and strategies for implementing SBIRT and MAUD in primary care settings in a facilitator-supported, tailored implementation study. Transl Behav Med 2025 Jan 16; 15(1). doi: 10.1093/tbm/ibae059..
Keywords: Primary Care, Implementation, Evidence-Based Practice, Alcohol Use, Substance Abuse, Behavioral Health, Screening
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
McPheeters M, O'Connor EA, Riley S
Pharmacotherapy for alcohol use disorder: a systematic review and meta-analysis.
Researchers conducted a literature review and analysis to compare efficacy of therapies for alcohol use disorder. Their findings supported the use of oral naltrexone at 50 mg/d and acamprosate as first-line pharmacotherapies in conjunction with psychosocial interventions for treating alcohol use disorder.
AHRQ-funded; 75Q80120D00007.
Citation: McPheeters M, O'Connor EA, Riley S . Pharmacotherapy for alcohol use disorder: a systematic review and meta-analysis. JAMA 2023 Nov 7; 330(17):1653-65. doi: 10.1001/jama.2023.19761..
Keywords: Medication, Alcohol Use, Evidence-Based Practice, Patient-Centered Outcomes Research
Huffstetler AN, Villalobos G, Brooks EM
The current state of alcohol screening and management in Virginia primary care practices: an evaluation of preventive service use.
This study used the recommendations of the US Preventive Services Task Force on screening and behavioral counseling for adults over 18 years for unhealthy alcohol use to examine the current state of alcohol screening and management in Virginia primary care practices. Clinicians were advised to use the following recommended screening instruments: the Alcohol Use Disorders Identification Test-Concise and or Single Alcohol Screening Question. Baseline data showed that clinicians appropriately screened only 10.8% of patients and only identified 9.6% as having risky drinking. However, 24% of patients reported risky drinking on a survey, demonstrating the implementation gap of the USPSTF recommendation and opportunity to improve health.
AHRQ-funded; HS027077.
Citation: Huffstetler AN, Villalobos G, Brooks EM . The current state of alcohol screening and management in Virginia primary care practices: an evaluation of preventive service use. Med Clin North Am 2023 Nov; 107(6s):e1-e17. doi: 10.1016/j.mcna.2023.07.001..
Keywords: U.S. Preventive Services Task Force (USPSTF), Alcohol Use, Screening, Substance Abuse, Behavioral Health, Primary Care, Evidence-Based Practice
Lee AK, Bobb JF, Richards JE
Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial.
This study’s goal was to evaluate an implementation intervention to increase (1) population-based alcohol-related prevention with brief interventions and (2) treatment of alcohol use disorder (AUD) in primary care implemented with a broader program of behavioral health integration. This stepped-wedge cluster randomized trial called the Sustained Patient-Centered Alcohol-Related Care (SPARC) trial included 22 primary care practices in an integrated health system in Washington state. Participants consisted of all adult patients 18 years or older with primary care visits from January 2015 to July 2018. The study included 7 waves, with practices randomly assigned launch dates. A total of 333,596 patients visited primary care (mean age, 48 years; 193,583 [58%] female; 234,764 [70%] White individuals). The proportion of patients with brief intervention was higher during SPARC intervention than usual care periods (57 vs 11 per 10,000 patients per month). The proportion with AUD treatment engagement did not differ during intervention and usual care. However, it did increase intermediate outcomes: screening (83.2% vs 20.8%), new AUD diagnosis (33.8 vs 28.8 per 10,000), and treatment initiation (7.8 vs 6.2 per 10,000).
AHRQ-funded; HS023173.
Citation: Lee AK, Bobb JF, Richards JE . Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial. JAMA Intern Med 2023 Apr;183(4):319-28. doi: 10.1001/jamainternmed.2022.7083.
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Patient-Centered Healthcare
Alexandre W, Muhammad H, Agbalajobi O
Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis.
The purpose of this study was to investigate the relationships between medical dialogues concerning alcohol use disorder (AUD) treatment, AUD treatment engagement, and mortality rates. The retrospective cohort study encompassed all patients diagnosed with cirrhosis and AUD receiving hepatology care within a single healthcare system in 2015. Baseline data on demographics, medical history, liver disease, and AUD treatment were examined. Information on AUD treatment discussions, initiation, alcohol cessation, and the subsequent 5-year mortality rates was gathered. Out of 436 patients with alcohol-related cirrhosis, 15% received AUD treatment at baseline, with 11% undergoing behavioral therapy, 2% receiving pharmacotherapy, and 1% obtaining both. Within the first year after the initial hepatology visit, 37 patients had AUD treatment, 51 remained in treatment, and 14 discontinued. Hepatology-documented AUD treatment recommendations were provided to 30% of patients, while 26% received primary care-documented recommendations. The majority of hepatology (86%) and primary care (88%) recommendations focused on behavioral therapy. Among patients with persistent alcohol use at baseline, AUD treatment after one year was significantly and independently associated with hepatology or primary care treatment discussions, and negatively associated with Medicaid insurance. When treatment discussions occurred in both settings, high treatment rates followed. Over five years, 35% of patients died. Ongoing alcohol use, age, hepatic decompensation, and hepatocellular carcinoma significantly contributed to mortality in the final survival model. In patients with alcohol-related cirrhosis, AUD treatment discussions were documented in fewer than half of hepatology and primary care encounters; however, such discussions were significantly correlated with AUD treatment receipt.
AHRQ-funded; HS019461.
Citation: Alexandre W, Muhammad H, Agbalajobi O . Alcohol treatment discussions and clinical outcomes among patients with alcohol-related cirrhosis. BMC Gastroenterol 2023 Feb 2; 23(1):29. doi: 10.1186/s12876-023-02656-z..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Clinician-Patient Communication, Communication
Alkhouri N, Almomani A, Le P
The prevalence of alcoholic and nonalcoholic fatty liver disease in adolescents and young adults in the United States: analysis of the NHANES database.
The purpose of this study was to evaluate the prevalence of non-alcoholic fatty liver disease (NAFLD) and alcohol-associated fatty liver disease (ALD) in a cohort of adolescents and young adults (AYAs) using transient elastography to directly measure hepatic steatosis and suspected fibrosis. AYA’s aged 15-39 years without viral hepatitis, pregnancy, or ALT/ AST greater than 500 U/L were included in the study. The researchers compared subjects with excessive alcohol consumption to those without and found that those with excessive alcohol consumption suspected ALD was present in 56.59% and suspected significant fibrosis was present in 12.3% and suspected advanced fibrosis was present in 6.31%. In subjects without excessive alcohol consumption, suspected NAFLD was present in 40.04%. In those with suspected NAFLD, suspected significant fibrosis was present in 31.07% and suspected advanced fibrosis was present in 20.15%. The study concluded that a significant percentage of AYAs are at risk for ALD and NAFLD and a subset of these subjects is at risk for significant fibrosis.
AHRQ-funded; HS026937.
Citation: Alkhouri N, Almomani A, Le P . The prevalence of alcoholic and nonalcoholic fatty liver disease in adolescents and young adults in the United States: analysis of the NHANES database. BMC Gastroenterol 2022 Jul 30;22(1):366. doi: 10.1186/s12876-022-02430-7..
Keywords: Children/Adolescents, Young Adults, Alcohol Use, Chronic Conditions
Singh AN, Sanchez V, Kenzie ES
Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: protocol of the ANTECEDENT study.
This study evaluates tailored implementation support to increase screening, brief intervention, referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) in primary care. It will explore how primary care clinics implement SBIRT and MAUD in routine practice and how practice facilitators vary implementation support across diverse clinic settings. It is anticipated that findings will inform how effectively to align implementation support to context, advance understanding of practice facilitator skill development over time, and ultimately improve detection and treatment of unhealthy alcohol use across diverse primary care clinics.
AHRQ-funded; HS027080.
Citation: Singh AN, Sanchez V, Kenzie ES . Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: protocol of the ANTECEDENT study. PLoS One 2022 Jun 28;17(6):e0269635. doi: 10.1371/journal.pone.0269635..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Care Management
Lin Y, Sharma B, Thompson HM
External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients.
This study’s objective was to validate a machine learning approach to alcohol screening using a natural language processing (NLP) classifier developed at an independent medical center. This retrospective cohort study took place at a midwestern US tertiary-care, urban medical center that has an inpatient structured universal screening model for unhealthy substance use and an active addiction consult service. The cohort included 57,605 unplanned admissions of adult patients between October 23, 2017 and December 31, 2019 with electronic health record (EHR) documentation of manual alcohol screening. The authors examined error in manual screening and reviewed discordance between the NLP classifier and AUDIT-derived reference. The classifier demonstrated adequate sensitivity and specificity for routine clinical use as an automated screening tool for identifying at-risk patients.
AHRQ-funded; HS026385.
Citation: Lin Y, Sharma B, Thompson HM . External validation of a machine learning classifier to identify unhealthy alcohol use in hospitalized patients. Addiction 2022 Apr;117(4):925-33. doi: 10.1111/add.15730..
Keywords: Alcohol Use, Behavioral Health, Screening, Electronic Health Records (EHRs), Health Information Technology (HIT)
Jonas DE, Barclay C, Grammer D
The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care.
This paper describes a randomized, controlled trial to evaluate the effect of primary care practice facilitation and telehealth services on evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use in primary care practices in North Carolina with 10 or fewer providers. The study will produce important evidence about the effect of practice facilitation on uptake of evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use when delivered on a large scale to small and medium-sized practices. The results of this rigorously conducted evaluation are expected to have a positive impact by accelerating the dissemination and implementation of evidence related to unhealthy alcohol use into primary care practices.
AHRQ-funded; HS027078.
Citation: Jonas DE, Barclay C, Grammer D . The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care. Trials 2021 Nov 16;22(1):810. doi: 10.1186/s13063-021-05641-7..
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Screening, Implementation
Zubiago J, Murphy M, Guardado R
Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic.
During the COVID-19 pandemic, due to lapses in harm reduction services, several public health experts forecasted subsequent increases in diagnosis of HIV in PWUD. As many inpatient hospitals reworked patient flow during the COVID-19 surge, the investigators hypothesized that HIV testing in PWUD would decrease. To answer this question, they compiled a deidentified list of hospitalized patients with electronic medical record indicators of substance use-a positive urine toxicology screen, prescribed medications to treat opioid use disorder, a positive CIWA score, or a positive CAGE score-admitted between January, 2020 and August, 2020.
AHRQ-funded; HS026008.
Citation: Zubiago J, Murphy M, Guardado R . Increased HIV testing in people who use drugs hospitalized in the first wave of the COVID-19 pandemic. J Subst Abuse Treat 2021 May;124:108266. doi: 10.1016/j.jsat.2020.108266..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Alcohol Use, Hospitalization, COVID-19, Public Health, Screening
Tong ST, Kato EU, Nix MP
´óÏóÊÓƵAuthor: Tong ST, Kato EU, Nix, MP, Bierman, AS
Help for primary care practitioners in addressing older adult alcohol and opioid use.
Unhealthy alcohol and opioid use are growing problems among older adults who are at increased risk for harms from both alcohol and opioid use. Primary care practices can play an important role in addressing this problem, but need support in implementing evidence-based practices. This article provides help for primary care practitioners in addressing older adult alcohol and opioid use.
AHRQ-authored.
Citation: Tong ST, Kato EU, Nix MP . Help for primary care practitioners in addressing older adult alcohol and opioid use. Generations Journal 2020-2021 Winter;44(4)..
Keywords: Elderly, Primary Care, Alcohol Use, Opioids, Substance Abuse, Behavioral Health
Shen NT, Bray J, Wahid NA
Evaluation of alcohol taxes as a public health opportunity to reduce liver transplant listings for alcohol-related liver disease.
Alcohol-related liver disease (ALD) is a leading indication for liver transplantation. In this study, the investigators evaluated alcohol taxes as a public health opportunity to reduce liver transplant listings for alcohol-related liver disease. The investigators concluded that transplant listings for ALD were directly associated with spirit consumption and inversely associated with spirits excise taxes. They indicate that these findings suggest a possible public health benefit of increasing excise taxes for spirits.
AHRQ-funded; HS000066.
Citation: Shen NT, Bray J, Wahid NA . Evaluation of alcohol taxes as a public health opportunity to reduce liver transplant listings for alcohol-related liver disease. Alcohol Clin Exp Res 2020 Nov;44(11):2307-15. doi: 10.1111/acer.14454..
Keywords: Alcohol Use, Policy, Transplantation
Steele DW, Becker SJ, Danko KJ
Brief behavioral interventions for substance use in adolescents: a meta-analysis.
Adolescents with problematic substance use (SU) are at risk for far-reaching adverse outcomes. The objective of this study was to synthesize the evidence regarding the effects of brief behavioral interventions for adolescents (12-20 years) with problematic SU. The investigators concluded that the use of a behavioral intervention called motivational interviewing reduced heavy alcohol use, alcohol use days, and SU-related problems in adolescents but did not reduce cannabis use days.
AHRQ-funded; 290201500002I.
Citation: Steele DW, Becker SJ, Danko KJ . Brief behavioral interventions for substance use in adolescents: a meta-analysis. Pediatrics 2020 Oct;146(4):e2020351. doi: 10.1542/peds.2020-0351..
Keywords: Children/Adolescents, Substance Abuse, Alcohol Use, Treatments
Wisk LE, Magane KM, Levy S
Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth.
Youth with chronic medical conditions (YCMC) use alcohol at levels similar to their healthy peers but face elevated risk for adverse health consequences. As salient reasons to abstain from or limit drinking (RALD) among YCMC are unknown, the investigators sought to identify clusters of RALD and test associations with use behaviors. The investigators concluded that for YCMC, RALD were complex but endorsement of multiple general and health-related RALD was associated with less use, and health concerns are especially prevalent.
AHRQ-funded; HS022986.
Citation: Wisk LE, Magane KM, Levy S . Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth. J Addict Med 2020 Jul/Aug;14(4):311-18. doi: 10.1097/adm.0000000000000603..
Keywords: Children/Adolescents, Alcohol Use, Behavioral Health, Vulnerable Populations, Substance Abuse
Burner E, Zhang M, Terp S
Feasibility and acceptability of a text message-based intervention to reduce overuse of alcohol in emergency department patients: controlled proof-of-concept trial.
The objective of this study was to assess the feasibility of and patient satisfaction with a text-based mHealth extension of an emergency department (ED) screening program to reduce risky alcohol use in low-income, urban patients. A case-control study was designed using a SMS text message-capable phones to receive mROAD (mobilizing to Reduce Overuse of Alcohol in the ED), an SMS text message-based extension of the ED screening program. mROAD is a 7-day program of twice-daily SMS text messages based on the NIH Health Rethinking Drinking campaign. Of 1028 patients screened, 9.2% exhibited risky alcohol use based on the Alcohol Use Disorders Identification Test (AUDIT) in the ED. Almost a quarter of the patients did not have an SMS text-messaging capable phone, leaving 76% eligible patients. Changes in behavior were similar between the two groups. The number of drinking days reported in the prior 30 days decreased by 5 and the number of heavy drinking days decreased by 4.1. Patients reported an 11-point increase in motivation to change alcohol use via the Change Questionnaire.
AHRQ-funded; HS022402.
Citation: Burner E, Zhang M, Terp S . Feasibility and acceptability of a text message-based intervention to reduce overuse of alcohol in emergency department patients: controlled proof-of-concept trial. JMIR Mhealth Uhealth 2020 Jun 4;8(6):e17557. doi: 10.2196/17557..
Keywords: Alcohol Use, Substance Abuse, Emergency Department, Telehealth, Health Information Technology (HIT), Screening, Prevention
Rogal S, Youk A, Zhang H
Impact of alcohol use disorder treatment on clinical outcomes among patients with cirrhosis.
Despite significant medical and economic consequences of coexisting alcohol use disorder (AUD) in patients with cirrhosis, little is known about AUD treatment patterns and their impact on clinical outcomes in this population. In this study the investigators aimed to characterize the use of and outcomes associated with AUD treatment in patients with cirrhosis. This retrospective cohort study included Veterans with cirrhosis who received Veterans Health Administration (VA) care and had an index diagnosis of AUD between 2011 and 2015.
AHRQ-funded; HS019461.
Citation: Rogal S, Youk A, Zhang H . Impact of alcohol use disorder treatment on clinical outcomes among patients with cirrhosis. Hepatology 2020 Jun;71(6):2080-92. doi: 10.1002/hep.31042..
Keywords: Alcohol Use, Substance Abuse, Patient-Centered Outcomes Research, Outcomes
Kuhns LM, Carlino B, Greeley K
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
This study looked at rates of substance use screening and related documentation among adolescents aged 12-17 in outpatient pediatric clinics in a large academic medical center. The authors abstracted a random sample of 127 records and coded clinical notes to describe screening cases and related characteristics. They then analyzed descriptive patterns within the data to calculate screening rates, characteristics of screening, and identify related factors. Rates of screening by providers was 72% for each common substance and a total of 6% of patients reported substance use during screening.
AHRQ-funded; HS026385.
Citation: Kuhns LM, Carlino B, Greeley K . A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice. Subst Abuse Treat Prev Policy 2020 May 25;15(1):36. doi: 10.1186/s13011-020-00276-4..
Keywords: Children/Adolescents, Substance Abuse, Screening, Ambulatory Care and Surgery, Alcohol Use, Practice Patterns, Primary Care

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