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.