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Implementing standardized substance use disorder screening in primary care.

Quinnette Jones1, Barbara Johnston, Holly Biola

  • 1Quinnette Jones is a medical instructor in the PA program at Duke University in Durham, N.C. Barbara Johnston is chief of HIV services at Lincoln Community Health Center and an adjunct associate professor in the Department of Medicine at Duke Health, both in Durham, N.C. Also at Lincoln Community Health Center, Holly Biola is chief of family medicine and physician quality improvement champion, Sandra Gomez is a satellite clinic administrator, and Carolyn Crowder is director of behavioral health. The authors have disclosed no potential conflicts of interest, financial or otherwise.

JAAPA : Official Journal of the American Academy of Physician Assistants
|September 26, 2018
PubMed
Summary

Primary care providers successfully implemented alcohol and substance use disorder screening, completing over 30,000 screenings. This initiative improved patient care and identified potential substance use problems.

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Area of Science:

  • Public Health
  • Primary Care Medicine
  • Quality Improvement

Background:

  • Alcohol and substance use disorders are prevalent and impact primary care.
  • Effective screening tools are needed for early identification in primary care settings.

Purpose of the Study:

  • To develop and implement a protocol for alcohol and substance use disorder screening in primary care.
  • To assess the feasibility and impact of this screening protocol.

Main Methods:

  • A quality improvement initiative utilized the Two Item Conjoint Screen.
  • A screening protocol was piloted by care teams and refined using quality improvement tools.
  • Primary care providers (PCPs) were surveyed, and screening data were collected via electronic health records.

Main Results:

  • Over 30,000 alcohol and substance use disorder screenings were completed in 2016.
  • 100% of PCPs found the screening helpful for identifying potential substance use problems.
  • 76% of PCPs reported improved overall patient care after initiating screening.

Conclusions:

  • Brief alcohol and substance use disorder screenings are easily implementable in primary care.
  • PCPs perceive these screenings as valuable for patient care.