186848 Evaluation of telephone-based screenings for alcohol and other drug problems

Tuesday, October 28, 2008

Mary Brolin, PhD , Schneider Institute for Health Policy, Brandeis University, Waltham, MA
Amy Rubin, PhD , Management Information Systems Unit, Boston University, Boston, MA
Daniel Alford, MD , Boston Medical Center, Boston, MA
Christopher W. Shanahan, MD, MPH , Boston Medical Center, Boston, MA
Theresa Kim, MD , Boston Medical Center, Boston, MA
Lee Ellenberg, LICSW , Boston Medical Center, Boston, MA
Indira Persand , Boston Medical Center, Boston, MA
Alissa Almeida, MPH , Boston Medical Center, Boston, MA
Jennifer Perloff, PhD , Schneider Institute for Health Policy, Brandeis University, Waltham, MA
Karen Pressman, MS, LCSW, CADAC , Bureau of Substance Abuse Services, Massachusetts Department of Public Health, Boston, MA
Carol Girard , Bureau of Substance Abuse Services, Massachusetts Department of Public Health, Boston, MA
With a growing body of evidence, policymakers and healthcare providers are beginning to promote and adopt screening and brief intervention strategies to identify and address alcohol and other drug problems among primary care patients. These strategies vary in their approach, sometimes bringing in trained health educators and other times integrating the SBI services within the current operations of primary care clinics. Within the MASBIRT (Massachusetts Screening, Brief Intervention, Referral and Treatment) Program, funded by the Substance Abuse and Mental Health Services Administration, we have developed and implemented a telephone-based screening system that screens patients prior to their scheduled healthcare appointment. Patients who screen positive for alcohol and other drug problems are then seen by a Health Promotion Advocate (HPA) for subsequent services. In this evaluation, we compare data on 300 patients who completed telephone-based screenings to a matched sample of 300 patients screened in-person by HPAs. We utilize a matched sample to minimize differences in results that are due to population characteristics. Using a chi-square test, the evaluation assesses whether the telephone-based screening results in significantly different screening results compared to in-persons screens and whether the distribution of patients needing brief intervention, brief treatment and referral to treatment differ significantly among those screened by telephone versus those screened in person. We also compare the cost per screen between the two approaches. The results will help policymakers and healthcare providers determine if automated telephone-based screening is a valid approach to screen their patient populations for alcohol and other drug problems.

Learning Objectives:
1. Identify the key elements of screening and brief intervention for alcohol and other drug problems. 2. Recognize the key data/technology issues that must be addressed to successfully implement an automated telephone screening system. 3. Assess the ability of automated telephone-based screenings to identify alcohol and other drug problems among primary care patients in comparison to in-person screenings. 4. Determine if there are benefits of using automated telephone calls for screening patients for alcohol and other drug problems within a comprehensive SBIRT program.

Keywords: Screening, Technology

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am part of the evaluation team on the project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.