142nd APHA Annual Meeting and Exposition

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Screening and detection of illicit and untreated drug use among community health center patients in Los Angeles County

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

Lisa Arangua, MPP , Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA
Mani Vahidi , Family Medicine, University of California, Los Angeles, Los Angeles, CA
Benjamin Chadwick , Family Medicine, UCLA, Los Angeles, CA
Barbara Leake, PhD , Department of 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
Lillian Gelberg, MD, MSPH , Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA
Background: Drug use screening and treatment is considered an “Essential Health Benefit” of the Affordable Care Act meaning community health centers (CHC’s) are required to provide it.   The UCLA Quit Using Drugs Intervention Trial (QUIT) developed a technologically innovative screening tool to assess current drug use behaviors among patients at large CHC’s in Los Angeles County.    This paper describes both the screening tool and the screening results from the QUIT study. 

Methods: The QUIT study was conducted at five of the largest CHC’s in Los Angeles County.  The screening tool combined the Electronic Materials Management Application (EMMA),   an innovative self-administered technology which uses talking tablet PCs (text and audio in English and Spanish) for improved reporting of sensitive drug use conditions, with the brief World Health Organization ASSIST screener.  Drug use was categorized as ‘low’, ‘moderate’ or ‘high’ risk.  A total of 3,915 completed the screening tool. 

Results: Average time to complete the screening tool was 4.9 minutes.  Among the patients that completed the tool, 71% scored in the no/low use categories, 22% scored in the moderate use category and 7% scored in the high use category.  The substances used most frequently were tobacco (32%), alcohol (21%), cannabis (20%), and crack/cocaine (12%). 

Conclusions: Community health centers and health plans are now required under the ACA to routinely screen all patients to improve the detection of drug use conditions.  The QUIT study provides evidence of a brief, highly innovative and effective tool for detecting sensitive drug use behaviors in busy CHC’s. 

Learning Areas:

Chronic disease management and prevention
Epidemiology
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe an innovative technological tool that screens for sensitive drug use behaviors. Describe the rates of moderate risk and high risk drug use behaviors among primary care patients in Los Angeles County. Discuss the screening tool as brief and effective method that could satisfy the ACA requirement concerning the screening and detection of drug use conditions.

Keyword(s): Community Health Planning, Drug Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I received an MPP in Health Policy, and I am a point person who help to spearhead the development of the Electronic Materials Management Application (EMMA) and the QUIT study screening tool.
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.

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