Telephone intervention aids clinicians in alcohol abuse screening
An automated telephone call prior to a primary care visit can encourage patients to discuss their alcohol consumption.
Interactive voice response (IVR) system screenings can help primary care clinicians effectively screen patients for potential alcoholism, according to a study published in the Journal of General Internal Medicine.
Gail L. Rose, PhD, Department of Psychiatry at the University of Vermont, and colleagues conducted a randomized controlled trial of IVR-based alcohol interventions in 1567 patients at 8 internal and family medicine practices affiliated with a university medical center. Patients were screened within the 3 days prior to their scheduled appointment.
The IVR system was preprogrammed with several questions relating to pain, smoking, drinking, depression, exercise, and weight; patients were also asked how many times they had consumed more than 4 (for women) or 5 (for men) alcoholic drinks in a day.
Patients who responded that they had engaged in that behavior at least once were eligible for a second IVR screening. The patients randomly chosen for the second screening were asked follow-up questions to identify a potential alcohol problem. A “brief intervention message” was then played, encouraging patients to discuss their drinking habits with their clinician; when asked, over half of the study participants said they were willing to hear advice related to either quitting or cutting down on drinking.
Patients randomized to the IVR brief intervention were more likely to report having discussed their alcohol consumption with their provider – 52% versus 44% in the usual treatment group – with 20% of those patients likely to bring up the topic themselves and receive an alcohol-related recommendation.
“About 25% to 30% of the general US population drinks alcohol at a level that, while not diagnosed as alcoholism, is high enough to qualify as unhealthy,” noted Dr Rose. “Heavy drinking has a strong influence on health, and can diminish the efficacy of some medications, among other negative effects.
“Previous research has shown that anything from a few minutes of simple advice to 2 sessions of 30-minute counseling can help,” Dr Rose concluded. “This is a recognized problem, and a very brief, in-office discussion about a patient's heavy drinking can have a very big impact.”
- Rose GL, Badger GJ, Skelly JM, et al. A randomized controlled trial of IVR-based alcohol brief intervention to promote patient-provider communication in primary care. J Gen Intern Med. 2016; doi: 10.1007/s1007/s11606-016-3692-4