ORIGINAL RESEARCH
Bonnie T. Jortberg, PhD, RD, CDCES; L. Miriam Dickinson, PhD; Douglas H. Fernald, MA; Andrew Bienstock, MHA; Dionisia de la Cerda, MPA; Kim Wiggins, MA, MS; Carolyn Swenson, MSPH, MSN, RN; Jennifer Halfacre; Stephanie Kirchner, MSPH, RD; W. Perry Dickinson, MD
Corresponding Author: Bonnie T. Jortberg, PhD, RD, CDCES; University of Colorado School of Medicine, Department of Family Medicine
Email: bonnie.jortberg@cuanschutz.edu
DOI: 10.3122/jabfm.2024.240048R1
Keywords: Alcohol Use Disorder, Colorado, Computer-Assisted Instruction, Counseling, Family Medicine, Patient Care Team, Patient-Centered Care, Primary Health Care; Process Assessment (Health Care), Quality of Care, Screening
Dates: Submitted: 02-02-2024; Revised: 04-26-2024; Accepted: 05-13-2024
FINAL PUBLICATION: |HTML| |PDF|
INTRODUCTION: Unhealthy alcohol use (UAU) is associated with preventable morbidity and mortality and accounted for more than 140,000 deaths per year in the U.S. during 2015-2019. The United States Preventive Services recommends routine screening for UAU in adults aged 18 years and older and pregnant persons, followed by brief counseling for a positive screening (B recommendation). Primary care practitioners can improve UAU outcomes by universally screening and offering brief counseling. This study aimed to increase screening, brief intervention, medication-assisted treatment (MAT), or referral for treatment (SBI/RT + MAT) in primary care practices.
METHODS: Cluster-randomized study to investigate 1) the effectiveness of virtual practice facilitation as a method to enhance implementation of SBI/RT + MAT and 2) the potential added benefit of utilizing alcohol use eLearning modules to guide and focus the process and content of virutal practice faciliation.
RESULTS: 61 primary care practices in Colorado enrolled in the study, with 43 primary practices completing the intervention and reporting 9-month data. Results show significant overall improvements in SBI/RT + MAT practice implementation scores from baseline to 9-month follow-up (p<.0001) and no differences between groups. The number of patients screened for UAU and/or AUD, receiving brief intervention, receiving an AUD diagnosis all significantly increased from baseline (p<.0001); and number receiving MAT also significantly increased (p < .0014).
DISCUSSION: Practice facilitation can assist primary care practices in improving SBI/RT + MAT processes and patient outcomes, with the results providing initial evidence for successful use of virtual practice facilitation.