Title

Screening, Brief Intervention, and Referral to Treatment for Alcohol Misuse in Primary Care

Date of Degree

12-2018

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Jean D. Dols

Advisor

Guillermo Rocha

Abstract

An annual average of 88,000 deaths in the United States from 2006 to 2010 has been attributed to alcohol misuse, defined as risky or heavy alcohol consumption. Heavy or risky alcohol use for all adults aged 65 and older and for women aged 18 and older is defined as consuming more than 7 drinks per week and/or 3 drinks per day. For men aged 18 to 65 years of age, heavy or risky alcohol use is defined as consuming more than 14 drinks a week and/or 4 drinks a day. Chronic alcohol misuse increases the incidence of heart problems, cognitive decline, hypertension, liver problems, and cancer. It is recommended to screen and treat patients for alcohol misuse in the primary care setting. The purpose of this project was to increase alcohol misuse screening and intervention for adults aged 18 years and older in an internal medicine practice. A screening and treatment protocol was established to align with the United States Preventive Services Task Force clinical recommendation guidelines. This protocol consisted of screening using the Alcohol Use Disorders Identification Test, brief intervention, and referral to treatment. During project implementation, 420 patients were screened and of those screened, 18 patients (4.3%) were positive for alcohol misuse. Of those that screened positive, 9 patients (50%) received brief intervention and verbal education in which 3 patients (33.3%) received educational handouts. Two patients were considered severe risk and both received brief intervention, refused the recommended referrals for psychiatric care, and considered follow-up treatments with the primary care physician. This project demonstrates that screening for alcohol misuse and providing brief intervention is feasible to implement in the primary care setting. Alcohol misuse awareness allows primary care providers to empower patients with the right tools to make informed decisions to their health.

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