Screening and Counseling for Unhealthy Alcohol Use in Primary Care Practices

Area of Science:

• Implementation Science
• Primary Care Medicine
• Public Health

Background:

• Unhealthy alcohol use is a major preventable cause of death and illness.
• Primary care practices infrequently screen for or discuss alcohol use with patients.

Purpose of the Study:

• To evaluate the effectiveness of practice facilitation in increasing the adoption of evidence-based screening and brief counseling for unhealthy alcohol use.

Main Methods:

• A 12-month implementation strategy involving quality improvement coaching, EHR support, and clinician training was applied to 21 primary care practices.
• The study tracked screening rates and the percentage of patients receiving brief counseling after positive screening.

Main Results:

• Mean screening rates for unhealthy alcohol use increased from 17.4% to 57.6% across 54,294 adult patients.
• The percentage of patients with documented brief counseling after positive screening rose from 0% to 32.3%.
• Outcomes were sustained after six months, though variability existed across practices.

Conclusions:

• Practice facilitation is an effective strategy for increasing the adoption of unhealthy alcohol use screening and counseling in primary care.
• This approach shows promise for reducing the significant public health burden of unhealthy alcohol use.