Impact of Multisite Patient Education on Pharmacotherapy for Veterans With Alcohol Use Disorder

Excessive alcohol use is a leading cause of preventable death in the United States. Despite the availability of effective alcohol use disorder (AUD) treatments, usage remain low. This quality improvement project explored the use of direct-to-consumer (DTC) patient education across multiple US Department of Veterans Affairs (VA) facilities to increase AUD treatment.

Patients with AUD or at high risk for AUD at 5 Veterans Integrated Service Network (VISN) 21 sites who were not receiving AUD pharmacotherapy were identified. Veterans were eligible for inclusion if they had an Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score ≥ 6 with an AUD diagnosis, or ≥ 8 without diagnosis, and a scheduled appointment with primary care, mental health, or a substance use disorder (SUD) health care practitioner between October 1, 2023, and January 31, 2024. The final cohort was mailed education materials about 2 weeks prior to their appointment. A comparator group from the previous year was identified using propensity score matching, and findings were assessed using logistic regression. The outcomes were assessed within 30 days of the scheduled visit, with the primary outcome being the initiation of pharmacotherapy and the secondary outcome being the placement of a consultation for mental health or SUD services.

DTC education was mailed to 1260 veterans. Primary and secondary outcomes did not find statistically significant differences between patients that received DTC education and the comparator group (P > .59).

Although the results of this study were not statistically significant, this project initiated conversations at the VISN around AUD and available treatments. Future research should focus on addressing primary care involvement in AUD treatment, assessing different methods for delivering DTC education, and its potential long-term impact in the treatment of AUD.