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Improving rheumatologists' screening for alcohol use and sexual activity
M T Britto1, S L Rosenthal, J Taylor
1Institute for Health Policy and Health Services Research, Department of Pediatrics, The Children's Hospital Medical Center, University of Cincinnati, Ohio 45229-3039, USA. maria.britto@chmcc.org
Archives of Pediatrics & Adolescent Medicine
|May 12, 2000
Summary
An office-based intervention significantly improved rheumatologists' screening for alcohol use and sexual activity in young patients with chronic rheumatic diseases. Despite improvements, time constraints and physician beliefs remain barriers to consistent screening.
Area of Science:
- Rheumatology
- Adolescent and Young Adult Medicine
- Public Health
Background:
- Adolescents and young adults with chronic rheumatologic conditions require comprehensive care addressing risk behaviors.
- Immunosuppressive therapies used in rheumatology can interact with alcohol use and sexual activity.
- Inadequate screening for these behaviors by healthcare providers is a known issue.
Purpose of the Study:
- To design, implement, and evaluate an office-based intervention to enhance rheumatologists' identification of at-risk behaviors in young patients.
- Specifically focused on improving screening for alcohol use and sexual activity.
Main Methods:
- A prospective intervention study was conducted in a Midwestern academic pediatric rheumatology practice.
- The study involved 10 rheumatologists and 178 patients (mean age 18.1 years).
- Screening rates for alcohol use and sexual activity were compared between baseline and intervention years.
Main Results:
- Alcohol use screening increased from 4.2% to 31.6% (P<.001); sexual activity screening rose from 12.4% to 36.2% (P<.001).
- Methotrexate use was associated with increased likelihood of alcohol screening (P=.02).
- Physicians cited time constraints, logistical issues, and discomfort as barriers to screening.
Conclusions:
- The intervention successfully improved screening rates for risky behaviors in young rheumatology patients.
- Despite positive outcomes, significant barriers including time, organization, and physician beliefs hinder widespread implementation.
- Further strategies are needed to overcome these barriers and ensure comprehensive patient care.