Implementation of the Alcohol Use Disorders Identification Test to Improve Practice in a Rural Primary Care Clinic
Abstract
The purpose of the project was to improve patient care and the clinical practice at the Barnesville Area Clinic (BAC) by introducing the providers to a guided method of evidence-based alcohol screening and brief intervention (SBI) for primary care patients. Previously, less formal methods for alcohol screening were utilized. The AUDIT with AUDIT-C modification screening form, which was created by the World Health Organization (WHO), was implemented. AUDIT is supported as an appropriate evidence-based method by the U.S. Preventative Services Task Force. Interventions were guided by the WHO's Brief Intervention Manual. The project was implemented in the Barnesville Area Clinic from June 2013 until August 2013. Thirty adult primary care patients, who presented for an annual physical exam, were offered the AUDIT screening form and brief intervention as indicated by individual scores. Of the 30 patients, six declined participation. Five participants filled out the screening tool, but did not complete the attached consent form. The remaining 19 participants completed the screening tool and consent form. Seventeen patients scored within Zone 1 (low risk) and two patients scored in Zone 2 (increased risk for alcohol misuse). No one scored in Zone 3 (high risk) or Zone 4 (alcohol dependence). The providers were surveyed on the perceived benefits and barriers of the project. Both providers strongly agreed the project was beneficial and the methods were easy to use. The impact on patient care varied, depending on individual results and willingness to participate in brief interventions. Barriers included suspected under-reporting of alcohol use, and patient resistance to discussing alcohol use. Despite the barriers, both providers felt that SBI methods could be utilized by the clinic in future practice. Recommendations for future research include offering SBI to broader patient populations at provider discretion to include not only annual physicals but those with suspected substance use on an episodic basis. Another recommendation is to seek out research on screening and brief intervention or to develop a method of SBI for prescription abuse.