142nd APHA Annual Meeting and Exposition

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A Primary Care Based Screening and Brief Intervention Efficacy Trial to Reduce "Risky" Drug Use

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 8:30 AM - 8:50 AM

Mani Vahidi , Family Medicine, University of California, Los Angeles, Los Angeles, CA
Lillian Gelberg, MD, MSPH , Family Medicine, University of California, Los Angeles, Los Angeles, CA
Ronald M. Andersen, PhD , Department of Health Services, UCLA School of Public Health, Los Angeles, CA
Julia Yacenda , Family Medicine, University of California, Los Angeles, Los Angeles, CA
Barbara Leake, PhD , Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
Lisa Arangua, MPP , Department of Family Medicine, UCLA, Los Angeles, CA
Background: The US government has encouraged primary care clinicians to integrate substance use and behavioral health into routine primary care of federally qualified health centers (FQHCs).

Methods: Single-blind randomized controlled trial of primary care clinic patients of five FQHCs in Los Angeles with 3-month follow-up. Adult patients with moderate (“risky”) drug use (ASSIST score 4-26) on a self-administered WHO ASSIST were invited to participate based on their highest scoring drug (HSD). Intervention patients received brief clinician advice to quit/reduce their drug use and two drug-use health education/reinforcement telephone sessions. The control group received usual care and cancer screening information.

Results: The sample’s mean age was 41.7 years; 63% were male; 38% were white, non-Latino, 34% Latino, 23% African American; 58% had income <= $500/month. Patients had been using their HSD an average of 20.4 years. The average reduction in HSD use was 3.95 days (p-value < 0.001) higher in the intervention than in the control group, after adjustment for covariates. The intervention effect was stronger in patients with high baseline HSD use (average 6.6 days greater reduction, p-value<0.001) and also stronger with 2 than with 0-1 telephone reinforcement sessions.

Conclusions: QUIT is the first US study focused on the primary care setting to demonstrate the efficacy of screening and brief intervention for risky drug use in adult patients. QUIT is also timely, as it offers an effective and efficient protocol that primary care providers can use as they begin offering more integrated and patient-centered care under the Affordable Care Act.

Learning Areas:

Social and behavioral sciences

Learning Objectives:
Assess whether a brief (3-4 minutes) QUIT Using Drugs Intervention Trial (QUIT) delivered to moderate ("risky") drug users would reduce drug use days more in an intervention group than in a control group

Keyword(s): Drug Abuse Prevention and Safety, Community Health Centers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the Fieldwork Director and Data Manager of two federally funded grants focusing on the prevention of drug dependence in primary care clinics. Among my scientific interests has been the development of an effective and efficient protocol that primary care providers can use as they begin offering more integrated and patient-centered care under the Affordable Care Act (ACA).
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.

Back to: 4005.0: Screening, Brief Intervention and Referral to Treatment Within Primary Care