Article Figures & Data
Figures
- Figure 1.
A pictoral representation of percentage of the US population drinking at various levels of risk for developing alcohol use disorder. Data are from Dawson et al14 and Grant et al15.
Tables
- Table 1.
Summary of Health Professionals' Characteristics Expressed as Absolute Numbers and Percentage
Characteristic (N = 69) Percentage Practice specialty Family physician 47 68.12 Internist 11 15.94 Physician assistant 5 7.24 Nurse practitioner 4 5.80 Other 2 2.90 Primary clinical setting University of New Mexico 22 31.88 Community Health Clinic 20 28.99 Indian Health Services 15 21.74 Other 6 8.70 Private practice 5 7.24 Missing 1 1.45 Experience (years) 1 to 5 7 10.14 6 to 10 8 11.60 11 to 15 10 14.49 16 to 20 8 11.60 21 to 25 12 17.39 More than 25 23 33.33 Missing 1 1.45 Total No. of staff in location where you see the most patients 1 to 5 11 15.94 6 to 11 13 18.84 11 or more 42 60.87 Missing 3 4.35 Gender Male 38 55.07 Female 31 44.93 Age range (years) 30 to 39 11 15.94 40 to 49 16 23.19 50 to 59 26 37.68 60 to 69 16 23.19 - Table 2.
Medical Provider Responses to Survey about Alcohol and Opiate Screening, Brief Intervention, and Referral to Treatment in Primary Care
Survey Question Alcohol Mean (SD) Opiate Mean (SD) Significance Testing (P) Thinking about your practice and patients generally, please indicate the degree to which alcohol/opiate use is a problem (Q1, Q17) 65 (22) 70 (22) .054 Compared to other health issues, addressing alcohol/opiate use problems is a top priority for our practice (Q6, Q21) 56 (21) 62 (24) .038 The leadership in my practice considers addressing alcohol/opiate use problems a priority (Q9, Q24) 56 (26) 59 (28) .421 As a primary care clinician, it is my responsibility to address alcohol/opiate use problems in my patients rather than referring them to others in the community (e.g. specialty clinics) (Q7, Q22) 61 (26) 62 (24) .794 Practice staff (other than physicians and mid-level practitioners) feel invested in helping patients with alcohol/opiate use problems (Q8, Q23) 50 (27) 49 (25) .769 Which of the following statements best describes the current situation in your practice for screening patients for alcohol/opiate use problems? (Q2, Q18) .020 Screening based on individual patient characteristics 50% 65% Screen at all patient visits 26% 15% Screen at well patient visits 22% 13% Never screen 1% 7% When patients are screened for alcohol/opiate use problems, which of the following statements best describes your approach? (Q3, Q19) .071 Clinician conducts screening 63% 77% Nurse or medical assistant 19% 10% Patient 16% 8% In thinking about your practice as a whole, which of the following best describes your approach to treatment for patients with alcohol/opiate use problems? (Q5, Q20) .068 Mix of providing SUD treatment in practice and referring to outside resources 55% 57% Only refer out to outside resources 37% 25% Patients in my community feel comfortable seeking treatment for alcohol/opiate use problems at our clinic (Q11, Q26) 52 (24) 48 (27) .204 Are you satisfied with how your practice addresses patients with alcohol/opiate use problems? (Q15, Q30) .147 Strongly satisfied 9% 12% Somewhat satisfied 49% 36% Somewhat dissatisfied 35% 39% Strongly dissatisfied 7% 13% Increasing our efforts to intervene in patients' alcohol/opiate use problems is important to this practice (Q14, Q29) 69 (22) 74 (21) .240 I believe that my practice has the ability to make improvements in how we deliver care for patients with alcohol/opiate use problems (Q13, Q28) 68 (21) 74 (23) .058 If you feel that your practice could improve its care for patients with alcohol/opiate use problems, please indicate how helpful each of the following possible strategies might be: Clinician training in, and structures to support use of, medications for alcohol/opiate use problems (e.g., naltrexone) (Q16a, Q31a) 66 (22) 68 (23) .456 A “collaborative care” approach (e.g., coordinated by a nurse care manager) (Q16b, Q31b) 75 (23) 76 (24) .654 Training in behavior change approaches (e.g., Motivational Interviewing) (Q16c, Q31c) 68 (20) 64 (25) .023 Increased practice coordination with other community resources (e.g., treatment, social supports, etc.) (Q16d, Q31d) 82 (14) 78 (19) .055 Effective instruments to help detect problem alcohol/opiate use (Q16e, Q31e) 67 (21) 68 (22) .718 Percentages may not add up to 100 due to rounding error. Numbers ranged from 1 to 100 unless a % is noted. Significance at P < .05 (bolded). “Q” refers to the question in the survey in Appendix 1.
SD, standard deviation; SUD, Substance Use Disorder.
Patient Category % Ranking 1st Priority % Ranking 2nd Priority % Ranking 3rd Priority Patients with dependent alcohol use 56.9 21.9 20.6 Patients with mild/moderate alcohol use 33.9 59.4 6.4 Patients with no current alcohol problems 9.2 18.8 73.0 Note: From Q 4 in the survey: We are interested in which patients you focus your alcohol screening efforts on. Please rank the following list (1 = highest priority; 3 = lowest priority) to show how you prioritize your efforts. The bolder numbers represent the highest percentage ranking at 1st, 2nd, and 3rd for where clinicians focus their alcohol screening efforts.
