Researchers from Dell Medical School at The University of Texas at Austin have made significant strides in addressing unhealthy alcohol use through a screening and telephone-based intervention program implemented at a large Federally Qualified Health Center system in Texas. This study showcased notable reductions in alcohol consumption among a diverse adult patient population, including individuals insured through county-based programs for the otherwise uninsured or low-income.
Unhealthy alcohol use is a significant contributor to various health conditions, such as liver disease, cardiovascular issues, and certain cancers. While universal alcohol use screening is recommended by the U.S. Preventive Services Task Force, interventions based on screening results are often underutilized in primary care settings.
The study, titled “Screening and Telephone-Based Intervention for Unhealthy Alcohol Use in a Diverse Federally Qualified Health Center System in Texas,” published in the Journal of General Internal Medicine, introduced a comprehensive telecare program designed to deliver brief interventions to patients with positive screening results. This program featured a two-session counseling program conducted by a bilingual, social work-trained counselor. Patients identified with severe alcohol use risk were offered pharmacotherapy and referrals to addiction medicine services. Follow-up assessments were conducted three to six months later to evaluate changes in alcohol consumption patterns.
A total of 3,959 patients underwent screening using the AUDIT-C questionnaire, with 16% screening positive for risky alcohol use. Factors associated with a higher likelihood of screening positive included being male, English-speaking, and having commercial insurance. Out of the 632 patients who screened positive, 412 engaged with the intervention, completing full AUDIT assessments to determine the severity of alcohol use.
Among the engaged patients, 68.2% had moderate alcohol use risk scores, while 31.8% had higher scores indicating greater risk. A significant proportion of participants completed counseling sessions, with some individuals receiving pharmacotherapy and addiction medicine referrals. Follow-up data revealed a mean reduction of 4.1 points in AUDIT scores, with Spanish-speaking patients showing greater reductions compared to English speakers.
Patients with higher initial AUDIT scores experienced more substantial decreases in scores, emphasizing the effectiveness of the intervention for individuals with greater alcohol use risk. The study highlighted the success of a telephone-based screening and brief intervention program in reducing unhealthy alcohol use within a diverse patient population, addressing barriers to care such as transportation and language through culturally responsive services.
While the program demonstrated significant progress, researchers underscored the need for increased engagement in pharmacotherapy, enhanced provider capacity, and improved patient follow-up, particularly for those with higher AUDIT scores. The study sheds light on the potential of telecare interventions in addressing unhealthy alcohol use and calls for continued efforts to optimize patient outcomes.
For more information, the study “Screening and Telephone-Based Intervention for Unhealthy Alcohol Use in a Diverse Federally Qualified Health Center System in Texas” can be accessed in the Journal of General Internal Medicine.
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