Advertisement

Community Mental Health Journal

, Volume 51, Issue 5, pp 546–553 | Cite as

Screening and Brief Intervention for Alcohol Misuse in Older Adults: Training Outcomes Among Physicians and Other Healthcare Practitioners in Community-Based Settings

  • Constance L. Coogle
  • Myra G. Owens
Brief Communication

Abstract

Screening and brief intervention (SBI) is increasingly available to older adults who engage in at-risk drinking. This study examined the extent to which SBI training influenced the willingness of healthcare providers in a community-based hospital and other clinical settings to promote the implementation of SBI. Ninety-three healthcare practitioners (primarily physicians, nurses, and social workers) who attended SBI training were asked about their intentions to apply the information in their professional practice, as well as their enthusiasm about recommending the training to others in their profession. Although there were no differences among the professions in terms of commitment to apply the information or level of comfort using the techniques, physicians were less interested in promoting SBI training among their colleagues. Although it may be more difficult to promote SBI in locations that don’t primarily provide mental health services, results suggest that primary care settings are precisely where training may be most useful.

Keywords

Alcohol Substance abuse treatment Continuing medical education Elderly At-risk drinking 

Notes

Acknowledgments

The authors wish to acknowledge the trainers, whose participation was made possible through funding from the Alcohol and Aging Awareness Group, Commonwealth of Virginia Department of Alcoholic Beverage Control: (1) Michael Weaver, MD, FASAM, Professor in the Department of Psychiatry and Behavioral Sciences at the University of Texas Health Sciences Center in Houston and Medical Director at the Center for Neurobehavioral Research on Addiction; (2) Caitlin K. Barthelmes, MPH with the Brief Negotiated Interview-Active Referral to Treatment (BNI-ART) Institute, School of Public Health at Boston University Medical Center.

References

  1. American College of Surgeons Committee on Trauma (2006). Alcohol Screening and Brief Intervention (SBI) for trauma patients: COT quick guide. Retrieved from https://www.facs.org/~/media/files/quality%20programs/trauma/publications/sbirtguide.ashx
  2. American Society of Addiction Medicine. (1997). Screening for addiction in primary care settings. Chevy Chase, MD: Author. Retrieved from http://www.asam.org/advocacy/find-a-policy-statement/view-policy-statement/public-policy-statements/2011/12/16/screening-for-addiction-in-primary-care-settings
  3. Anderson, P. (1985). Managing alcohol problems in general practice. British Medical Journal, 290, 1873–1875.PubMedCentralPubMedCrossRefGoogle Scholar
  4. Anderson, P., Aromaa, S., Rosenbloom, D. & Enos, G. (2008). Screening and brief intervention: Making a public health difference. Boston, MA: Join Together, Boston University School of Public Health. Retrieved from http://wwwtest.adp.ca.gov/SBI/pdfs/SBI_RPT_join_together.pdf
  5. Arie, T. H. D. (1984). Education in the care of the elderly. Bulletin of the New York Academy of Medicine, 61(6), 492–500.Google Scholar
  6. Babor, T. F., McRee, B. G., Kassebaum, P. A., Grimaldi, P. L., Ahmed, K., & Bray, J. (2007). Screening, brief intervention, and referral to treatment (SBIRT): Toward a public health approach to the management of substance abuse. Substance Abuse, 28(3), 7–30.PubMedCrossRefGoogle Scholar
  7. Barry, K. L., Blow, F. C., Cullinane, P., Gordon, C., & Welsh, D. (2006). The effectiveness of implementing a brief alcohol intervention with older adults in community settings. National Council on Aging, Center for Healthy Aging. Retrieved from http://www.ncoa.org/improve-health/center-for-healthy-aging/content-library/BI_StayingHealthyProject.pdf
  8. Barry, K. L., Blow, F. C., Willenbring, M., McCormick, R., Brockman, L., & Visnic, S. (2004). Use of alcohol screening and brief interventions in primary care settings: Implementation and barriers. Substance Abuse, 25(1), 27–36.PubMedCrossRefGoogle Scholar
  9. Blow, F. C., & Barry, K. L. (2000). Older patients with at-risk and problem drinking patterns: New developments in brief interventions. Journal of Geriatric Psychiatry and Neurology, 13(3), 115–123.PubMedCrossRefGoogle Scholar
  10. Blow, F., Gillespie, B. W., Barry, K. L., Mudd, S. A., & Hill, E. M. (1998). Brief screening for alcohol problems in elderly populations using the Short Michigan Alcohol Test-Geriatric Version (SMAST-G). Alcoholism: Clinical and Experimental Research, 22(3), 165A.Google Scholar
  11. Bush, K., Kivlahanm, D. R., McDonell, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Archives of Internal Medicine, 158, 1789–1795.PubMedCrossRefGoogle Scholar
  12. Casswell, S., & McPherson, M. (1984). Attitudes of New Zealand general practitioners to alcohol-related problems. Journal of Studies on Alcohol, 44, 342–351.CrossRefGoogle Scholar
  13. Center for Substance Abuse Treatment (1999). Brief interventions and brief therapies for substance abuse. Treatment Improvement Protocol (TIP) Series, No. 34. HHS Publications No. (SMA) 12-3952. Rockville, MD: Substance Abuse and Mental Health Services Administration, 1999. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64947/pdf/TOC.pdf
  14. Center for Substance Abuse Treatment (2005). Substance abuse relapse prevention: A group treatment approach for older adults (DHHS Publication No. SMA 05-4053). Rockville, MD: Substance Abuse and Mental Health Services Administration, Department of Health and Human Services.Google Scholar
  15. Clement, S. (1986). The identification of alcohol-related problems by general practitioners. British Journal of Addiction, 81, 257–264.PubMedCrossRefGoogle Scholar
  16. Coogle, C. L., Osgood, N. O., & Parham, I. A. (2000). A statewide model detection and prevention program for geriatric alcoholism and alcohol abuse: Increased knowledge among service providers. Community Mental Health Journal, 36(2), 137–148.Google Scholar
  17. Coogle, C. L., Osgood, N. O., & Parham, I. A. (2001). Follow-up to the statewide model detection and prevention program for geriatric alcoholism. Community Mental Health Journal, 37(5), 381–391.Google Scholar
  18. Estee, S., & Huber, A. (2010). Washington state screening, brief intervention, and referral to treatment program: Final program performance report (October 1, 2003 through September 30, 2009). Washington State Department of Social and Health Services, Research and Data Analysis Division. Retrieved from http://www.dshs.wa.gov/pdf/ms/rda/research/4/83.pdf
  19. Estee, S., Wickizer, T., He, L., Shah, M. F., & Mancuso, D. (2010). Evaluation of the Washington state screening, brief intervention, and referral to treatment project. Medical Care, 48, 18–24.PubMedCrossRefGoogle Scholar
  20. Fleming, M. F., Manwell, L. B., Barry, K. L., Adams, W., & Stauffacher, E. A. (1999). Brief physician advice for alcohol problems in older adults: A randomized community-based trial. Journal of Family Practice, 48(5), 378–384.PubMedGoogle Scholar
  21. Fleming, M. F., Mundt, M. P., French, M. T., Manwell, L. B., Stauffacher, E. A., & Barry, K. L. (2002). Brief physician advice for problem drinkers: Long-term efficacy and benefit-cost analysis. Alcoholism, Clinical and Experimental Research, 26(1), 36–43.PubMedCrossRefGoogle Scholar
  22. Friedmann, P., McCulloch, D., Chin, M., & Saltz, R. (2000). Screening and intervention for alcohol problems: A national survey of primary care physicians and psychiatrists. Journal of General Internal Medicine, 15, 84–91.PubMedCentralPubMedCrossRefGoogle Scholar
  23. Fussell, H. E., Rieckmann, T. R., & Quick, M. B. (2011). Medicaid reimbursement for screening and brief intervention for substance misuse. Psychiatric Services, 62(3), 306–309.PubMedCrossRefGoogle Scholar
  24. Higgins-Biddle, J., Hungerford, D., & Cates-Wessel, K. (2009). Screening and Brief Interventions (SBI) for unhealthy alcohol use: A step-by-step implementation guide for trauma centers. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Retrieved from http://www.cdc.gov/InjuryResponse/alcohol-screening/pdf/SBI-Implementation-Guide-a.pdf
  25. Hui, E. C. (2005). The centrality of patient–physician relationship to medical professionalism: An ethical evaluation of some contemporary models. Hong Kong Medical Journal, 11(3), 222–223.PubMedGoogle Scholar
  26. Institute of Medicine (2012). The mental health and substance use workforce for older adults: In whose hands? The National Academies Press: Washington, DC. Retrieved from: http://www.iom.edu/Reports/2012/The-Mental-Health-and-Substance-Use-Workforce-for-Older-Adults.aspx
  27. Lin, J. C., Karno, M. P., Barry, K. L., Blow, F. C., Davis, J. W., Tang, L., et al. (2010). Determinants of early reductions in drinking in older at-risk drinkers participating in the intervention arm of a trial to reduce at-risk drinking in primary care. Journal of the American Geriatrics Society, 58, 227–233.PubMedCentralPubMedCrossRefGoogle Scholar
  28. Lin, J. C., Karno, M. P., Tang, L., Barry, K. L., Blow, F. C., Davis, J. W., et al. (2009). Do health educator telephone calls reduce at-risk drinking among older adults in primary care? Journal of General Internal Medicine, 25(4), 334–339.CrossRefGoogle Scholar
  29. McKnight-Eily, L. R., Liu, Y., Brewer, R. D., Kanny, D., Lu, H., Denny, C. H., et al. (2011). Vital signs: Communication between health professionals and their patients about alcohol use—44 states and the District of Columbia, 2011. Morbidity and Mortality Weekly Report, 63(1), 16–22.Google Scholar
  30. Miller, W. R., & Rollnick, S. (1991). Motivational interviewing: Preparing people to change addictive behavior. New York: Guilford.Google Scholar
  31. Miller, W. R., & Sanchez, V. C. (1993). Motivating young adults for treatment and lifestyle change. In G. Howard (Ed.), Issues in alcohol use and misuse in young adults (pp. 55–82). Notre Dame, IN: University of Notre Dame Press.Google Scholar
  32. Moore, A. A., Blow, F. C., Hoffing, M., Welgreen, S., Davis, J. W., Lin, J. C., et al. (2011). Primary care-based intervention to reduce at-risk drinking in older adults: a randomized controlled trial. Addiction, 106, 111–120. doi: 10.1111/j.1360-0443.2010.03229.x.PubMedCentralPubMedCrossRefGoogle Scholar
  33. Moore, A. A., Blow, F. C., Hoffing, M., Welgreen, S., Tang, L., & Barry, K. (2010). Reducing at-risk drinking among older adults in primary care: The healthy living as you age study. The Gerontologist, 50(suppl. 1), 167.Google Scholar
  34. Mundt, M. P., French, M. T., Roebuck, M. C., Manwell, L. B., & Barry, K. L. (2005). Brief physician advice for problem drinking among older adults: An economic analysis of costs and benefits. Journal of Studies on Alcohol, 66(3), 389–394.PubMedCrossRefGoogle Scholar
  35. National Institute on Alcohol Abuse and Alcoholism (NIAAA) (2005). Brief interventions. Alcohol Alert (No. 66). Bethesda, MD: National Institutes of Health, NIAAA. Retrieved from http://pubs.niaaa.nih.gov/publications/AA66/AA66.htm
  36. Peter D. Hart Research Associates, Inc (1998). The road to recovery. A landmark study on public perceptions of alcoholism and barriers to treatment. Washington, DC: The Rush Recovery Institute.Google Scholar
  37. Physicians Leadership on National Drug Policy (2002). Screening and intervention in health care settings: Making it a vital sign. Retrieved from http://www.plndp.org/Physician_Leadership/Resources/projvital.pdf
  38. Roy, A. K., & Miller, M. M. (2010). Parity and the medicalization of addiction treatment. Journal of Psychoactive Drugs, 42(2), 115–120.PubMedCrossRefGoogle Scholar
  39. Roy, A. K., & Miller, M. M. (2012). The medicalization of addiction treatment professionals. Journal of Psychoactive Drugs, 44(2), 107–118.PubMedCrossRefGoogle Scholar
  40. Rush, B. R., Bass, M., Stewart, M. A., McCracken, E., Labreque, M., & Bondy, S. (1994). Detecting, preventing, and managing patients’ alcohol problems. Canadian Family Physician, 40, 1557–1566.PubMedCentralPubMedGoogle Scholar
  41. Schonfeld, L., King-Kallimanis, B. L., Duchene, D. M., Etheridge, R. L., Herrera, J. R., Barry, K. L., et al. (2010). Screening and brief intervention for substance misuse among older adults: The Florida BRITE project. American Journal of Public Health, 99(7), 1–7.Google Scholar
  42. Sharp, L., & Vacha-Haase, T. (2011). Physician attitudes regarding alcohol use screening in older adult patients. Journal of Applied Gerontology, 30(2), 226–240.CrossRefGoogle Scholar
  43. Sorocco, K., & Ferrell, S. (2006). Alcohol use among older adults. Journal of General Psychology, 133, 453–467.PubMedCrossRefGoogle Scholar
  44. Substance Abuse and Mental Health Services Administration (2011). Leading change: A plan for SAMHSA’s roles and actions 2011–2014. HHS Publication No. (SMA) 11-4629. Rockville, MD: Substance Abuse and Mental Health Services Administration. Retrieved from http://store.samhsa.gov/product/SMA11-4629
  45. U.S. Preventive Services Task Force. (2004). Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: Recommendation statement. Annals of Internal Medicine, 140, 554–556.CrossRefGoogle Scholar
  46. Warburg, M. M., Cleary, P. D., Rohman, M. E., Barnes, H. N., Aronson, M., & Delbanco, T. L. (1987). Residents’ attitudes, knowledge, and behavior regarding diagnosis and treatment of alcoholism. Journal of Medical Education, 62, 497–503.PubMedGoogle Scholar
  47. Zimmerman, M., Farber, N. J., Hartung, J., Lush, D. T., & Kuzma, M. A. (1994). Screening for psychiatric disorders in medical patients: A feasibility and patient acceptance study. Medical Care, 32(6), 603–608.PubMedCrossRefGoogle Scholar
  48. Zimmerman, M., Lush, D. T., Farber, N. J., Hartung, J., Plescia, G., Kuzma, M. A., et al. (1996). Primary care patients’ reactions to mental health screening. International Journal of Psychiatry in Medicine, 26(4), 431–441.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Virginia Center on Aging, School of Allied Health ProfessionsVirginia Commonwealth UniversityRichmondUSA

Personalised recommendations