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Researchers from Dell Medical School at The University of Texas at Austin successfully implemented a screening and telephone-based intervention program for unhealthy alcohol use at a large Federally Qualified Health Center system in Texas. The study demonstrated significant reductions in alcohol use among a diverse adult patient population, including those insured through county-based programs for otherwise uninsured or low-income individuals.
Unhealthy alcohol use contributes to increased risks of multiple health conditions, including liver disease, cardiovascular disease, and various cancers. Recommendations for universal alcohol use screening (recommended by the U.S. Preventive Services Task Force) are in place, but interventions based on screening results remain underutilized in many primary care settings.
In the study “Screening and Telephone-Based Intervention for Unhealthy Alcohol Use in a Diverse Federally Qualified Health Center System in Texas,” published in the Journal of General Internal Medicine, researchers developed a multifaceted telecare program to provide brief interventions to patients with positive screens.
The intervention included a two-session, evidence-based counseling program administered by a bilingual, social work–trained counselor. Patients identified with severe alcohol use risk were offered pharmacotherapy and referrals to addiction medicine services. Follow-up assessments were completed in three to six months to evaluate changes in alcohol use patterns.
A total of 3,959 patients were screened using the AUDIT-C questionnaire. Of these, 16% (632) screened positive for risky alcohol use. Patients more likely to screen positive included men, English speakers, and those with commercial insurance. Researchers successfully engaged 412 patients, completing full AUDIT assessments to determine the severity and risk levels of alcohol use.
Of the patients engaged, 68.2% (281) had AUDIT scores indicating moderate risk (≤12), while 31.8% (131) had higher scores (>12). 97% of participants completed one counseling session, and 72% completed two. Among those with high initial AUDIT scores, 19 patients received pharmacotherapy, and 13 engaged with addiction medicine services.
Follow-up data were collected for 251 patients (61%). Results showed a mean AUDIT score reduction of 4.1 points (95% CI -3.4, -4.7). Spanish-speaking patients showed greater reductions than English speakers, with no significant differences observed across other demographic groups.
Patients with higher initial AUDIT scores (>12) experienced more substantial decreases in scores (mean reduction of 7.99) compared to those with moderate scores (mean decrease of 2.25).
The study illustrates that a telephone-based screening and brief intervention program can effectively reduce unhealthy alcohol use in a diverse patient population within a Federally Qualified Health Center setting. The approach also mitigated barriers to care, such as transportation and language, by offering bilingual, culturally responsive services.
Researchers highlight that while significant progress was made, further efforts are needed to increase pharmacotherapy engagement, enhance provider capacity, and improve sustained patient follow-up, particularly for those with higher AUDIT scores.
More information:
Michael Pignone et al, Screening and Telephone-Based Intervention for Unhealthy Alcohol Use in a Diverse Federally Qualified Health Center System in Texas, Journal of General Internal Medicine (2024). DOI: 10.1007/s11606-024-09240-5
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Screening with telephone-based intervention reduces risky alcohol use in Texas study (2024, December 18)
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