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306312
Screening scores and clinical markers: A step toward integration of behavioral health and primary care
Tuesday, November 18, 2014
Jonathan Agley, PhD, MPH
,
School of Public Health, Indiana University, Bloomington, Indiana University, Bloomington, IN
Michelle Lenox, PhD
,
Department of BioHealth Informatics, Indiana University, Purdue University, Indianapolis (IUPUI), Indianapolis, IN
Lisa Session, BSW
,
Midtown Community Mental Health Center, Indianapolis, IN
Dean Babcock, LCSW, ACSW
,
Midtown Community Mental Health Center, Indianapolis, IN
Joseph Bartholomew, MSW, LCAC, CHES
,
Coordinator, SBIRT Program, Midtown Mental Health, Indianapolis, IN
Joan Carlson, PhD
,
School of Social Work, Indiana University, Purdue University, Indianapolis (IUPUI), Indianapolis, IN
Ruth Gassman, PhD
,
School of Public Health, Indiana University, Bloomington, Indiana Prevention Resource Center, Bloomington, IN
Richard Goldsworthy, PhD, MSEd
,
Academic Edge, Inc., Bloomington, IN
Angela McNelis, PhD, RN, ANEF
,
School of Nursing, Indiana University, Indianapolis, IN
Julie Vannerson, MD
,
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
Cynthia Wilson, RN
,
Midtown Community Mental Health Center, Indianapolis, IN
David Crabb, MD
,
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN
Alcohol use disorders (AUDs) are associated with numerous comorbid alcohol-attributable outcomes, both directly (e.g., alcohol-induced pancreatitis) and indirectly (e.g., major depression). Four to 5% of the United States population meets the criteria for an AUD. However, as Screening, Brief Intervention, and Referral to Treatment (SBIRT) more frequently is integrated into primary care, medical providers increasingly are aware of the additional 20% of patients who drink at problematic levels. There is a need to identify clinical markers that are associated with the multiple levels of alcohol use identified by evidence-based screening tools. Identifying these markers will allow for more better-targeted delivery of intervention or treatment services to patients. This study presents pilot data intended to support the further exploration of such a value set.
The researchers performed a secondary analysis of data taken from 9,954 patients who received an SBIRT prescreening at a single primary care medical center in Indianapolis between January 2012 and June 2013. Patient data were examined for comorbid clinical markers if the patient reported a positive score on the AUDIT-C and separately was diagnosed with an AUD (n=100). Eight clinical markers were selected based on prior research and known associations with heavy alcohol use; five were present in more than 50% of the sample: rib fractures, high blood pressure, hyper-triglyceridemia, tobacco use, and prescriptions for anxiety. There is a need for additional research into whether the presence of these conditions can predict problematic alcohol use, even among patients who do not report heavy use.
Learning Areas:
Chronic disease management and prevention
Public health or related research
Learning Objectives:
Explain the need to expand the study of clinical markers that are comorbid with alcohol use disorders (AUDs) to account for risky or problematic alcohol use that may not qualify as an AUD.
List several of the clinical markers that should be included when investigating the association between evidence-based screening scores and other medical data in primary care.
Keyword(s): Alcohol Use, Screening Instruments
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am a research faculty member at Indiana University as well as the evaluator and data analyst for three federally-funded SBIRT projects that have been funded since 2009. I oversaw many aspects of the data collection and provided the sample for analysis, and I assisted with the analytic design for this 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.
