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. The study showcased notable reductions in alcohol consumption among a diverse adult patient population, including individuals insured through county-based programs for the uninsured or low-income.
Unhealthy alcohol use is a leading contributor to various health conditions like liver disease, cardiovascular issues, and certain cancers. Despite recommendations for universal alcohol screening, interventions based on screening results are underutilized in many primary care settings.
In the research 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, a comprehensive telecare program was developed to deliver brief interventions to patients with positive screening results.
The intervention comprised a two-session counseling program led by a bilingual, social work–trained counselor. Patients identified with severe alcohol use risks were offered pharmacotherapy and referrals to addiction medicine services. Follow-up assessments were conducted three to six months later to assess changes in alcohol consumption patterns.
Out of the 3,959 patients screened using the AUDIT-C questionnaire, 16% (632) were identified as having risky alcohol use. Factors associated with a higher likelihood of screening positive included being male, English-speaking, and having commercial insurance. The study successfully engaged 412 patients, conducting full AUDIT assessments to determine alcohol use severity.
Among the engaged patients, 68.2% (281) exhibited moderate alcohol use risk (≤12), while 31.8% (131) had higher scores (>12). Most participants completed at least one counseling session, with 72% completing two sessions. For individuals with high initial AUDIT scores, 19 received pharmacotherapy, and 13 engaged with addiction medicine services.
Follow-up data from 251 patients (61%) revealed a mean AUDIT score reduction of 4.1 points (95% CI -3.4, -4.7). Spanish-speaking patients demonstrated greater score reductions compared to English speakers, with no significant variations across other demographic groups.
Patients with higher initial AUDIT scores (>12) experienced more substantial score reductions (mean decrease of 7.99) than those with moderate scores (mean decrease of 2.25).
The study highlights the effectiveness of a telephone-based screening and brief intervention program in reducing unhealthy alcohol consumption in a diverse patient population within a Federally Qualified Health Center setting. This approach also addresses barriers to care such as transportation and language by providing bilingual, culturally responsive services.
While significant progress was achieved, researchers emphasize the need for further efforts to enhance pharmacotherapy engagement, boost provider capacity, and improve sustained patient follow-up, particularly for individuals with higher AUDIT scores.
For more information, refer to the study published in the Journal of General Internal Medicine by Michael Pignone et al. (DOI: 10.1007/s11606-024-09240-5).
© 2024 Science X Network
