Trauma Centers Prove Good Venues for SBIRT: The Cohort Members Had Received Funding from SAMSHA to Set Up Services in Diverse Settings

By Matthews, Renee | Clinical Psychiatry News, December 2009 | Go to article overview

Trauma Centers Prove Good Venues for SBIRT: The Cohort Members Had Received Funding from SAMSHA to Set Up Services in Diverse Settings


Matthews, Renee, Clinical Psychiatry News


BETHESDA, MD. -- Screening, brief intervention, and referral to treatment programs in large-volume general medical settings captured a range of patients at risk for alcohol, tobacco, and other drug use disorders that otherwise might not have been detected, findings in an evaluation of data from a cohort of centers that implemented the program show.

Emergency/trauma centers, in particular, are effective as screening, brief intervention, and referral to treatment (SBIRT) venues, because they serve high proportions of at-risk individuals, Francis K. Del Boca, Ph.D., reported at the annual conference of the Association for Medical Education and Research in Substance Abuse.

Forty-five percent of patients who screened positive for tobacco or at-risk alcohol use also reported using an illicit drug, said Dr. Del Boca of the University of Connecticut Health Center in Farmington. She noted that those who screened positive "often had ancillary physical, medical, and mental health issues that required consideration in the treatment referral process" and that being able to do so at an earlier stage could have an impact on patient outcomes.

The centers in the current analysis were based in California, Illinois, New Mexico, Pennsylvania, Texas, Washington State, and Cook Inlet in Alaska--together referred to as cohort 1 in the analysis. The cohort members had received funding from the Substance Abuse and Mental Health Services Administration in 2003 to set up SBIRT services in several diverse settings.

Other centers have since received funding as well, but the current analysis was based on data from the first cohort.

The researchers sought to establish the effectiveness, availability, and efficiency of the program by reviewing documents from the centers and conducting site visits that included interviewing and observing program providers and administrators.

There were three service delivery models--in-house generalist, in-house specialist, or contracted specialist--and when the researchers broke down the services into the categories of pre-screening, screening, brief intervention (BI), or brief treatment (BT), the contracted specialist model seemed to work well across all of the categories, especially for screening, BI, and BT.

Providers in the hospital-outpatient setting recommended screening and feedback to 87% of patients, but BI, BT, and referral to treatment (RT) to only 8%, 3%, and 3% of patients, respectively. Likewise, federally qualified community health center providers recommended screening to most patients (85%), but their rates for BI, BT, and RT were also notably lower--11%, 3%, and 1%, respectively. By comparison, although only 70% of emergency/trauma patients were recommended for screening and feedback, the corresponding percentages for BI, BT, and RT recommendations were 18, 5, and 8. …

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