Researchers from Dell Medical School at The University of Texas at Austin have successfully implemented a screening and telephone-based intervention program for unhealthy alcohol use at a large Federally Qualified Health Center system in Texas. This study has shown significant reductions in alcohol use among a diverse adult patient population, including those insured through county-based programs for otherwise uninsured or low-income individuals.
Unhealthy alcohol use is known to contribute to increased risks of various health conditions, including liver disease, cardiovascular disease, and different types of cancers. Despite recommendations for universal alcohol use screening by the U.S. Preventive Services Task Force, interventions based on screening results are underutilized in many primary care settings.
In their study titled “Screening and Telephone-Based Intervention for Unhealthy Alcohol Use in a Diverse Federally Qualified Health Center System in Texas,” researchers developed a multifaceted telecare program to provide brief interventions to patients who screened positive for risky alcohol use. The intervention included a two-session, evidence-based counseling program administered by a bilingual, social work-trained counselor. Patients with severe alcohol use risk were offered pharmacotherapy and referrals to addiction medicine services, with follow-up assessments conducted in three to six months to evaluate changes in alcohol use patterns.
A total of 3,959 patients were screened using the AUDIT-C questionnaire, with 16% (632) screening positive for risky alcohol use. Patients more likely to screen positive included men, English speakers, and those with commercial insurance. The researchers engaged 412 patients, completing full AUDIT assessments to determine the severity and risk levels of alcohol use.
Among the engaged patients, 68.2% had moderate risk AUDIT scores (≤12), while 31.8% had higher scores (>12). The majority of participants completed the counseling sessions, with some receiving pharmacotherapy and addiction medicine services. Follow-up data revealed a mean AUDIT score reduction of 4.1 points, with Spanish-speaking patients showing greater reductions than English speakers.
Patients with higher initial AUDIT scores experienced more substantial decreases in scores compared to those with moderate scores. The study demonstrates that a telephone-based screening and brief intervention program can effectively reduce unhealthy alcohol use in a diverse patient population within a Federally Qualified Health Center, overcoming barriers to care such as transportation and language.
While significant progress was made, the researchers emphasize the need for further efforts to increase pharmacotherapy engagement, enhance provider capacity, and improve sustained patient follow-up, particularly for those with higher AUDIT scores. This study provides valuable insights into addressing unhealthy alcohol use and improving patient outcomes in primary care settings.
For more information, the study titled “Screening and Telephone-Based Intervention for Unhealthy Alcohol Use in a Diverse Federally Qualified Health Center System in Texas” can be found in the Journal of General Internal Medicine. © 2024 Science X Network.
