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Excessive alcohol use is far from an isolated problem. Only four percent of the U.S. population meets the diagnostic criteria of having an alcohol use disorder, but almost one in three U.S. adults falls into the “risky” drinking category, and 38 million U.S. adults “binge drink” each year (defined as drinking more than four drinks for women and five drinks for men within a two-hour period).1,2
Most of these drinkers are unaware of the dangers, and many probably consider themselves merely “social” drinkers. However, risky alcohol use can lead to motor vehicle crashes, arrest, intimate partner violence, and medical problems including hypertension, gastritis, liver disease, and cancer.3 Moreover, if a woman drinks while pregnant, the child may be born with a fetal alcohol spectrum disorder, causing lifelong developmental and intellectual disabilities.
As a family physician, you can efficiently and productively address risky drinking with the many patients in your practice who are affected by it. Alcohol screening and brief intervention (aSBI) has been shown to reduce risky drinking and is similar to the blood pressure or tobacco screening you likely already perform in your available for payment. This article describes three steps to seamlessly implement aSBI into your practice:
1) Establish a practice workflow,
2) Incorporate aSBI prompts into your electronic health record (EHR) system,
3) Ensure appropriate coding to receive payment.
VIDEO: BRIEF ALCOHOL INTERVENTION
Alicia Kowalchuk, DO, discusses incorporating alcohol screening into patient visits and demonstrates a brief intervention.
Copyright © 2017 Alicia Kowalchuk, DO
Adding aSBI to the practice workflow
Every practice is unique, so implementing aSBI can be handled in multiple ways. Nevertheless, there are several guiding principles.
First, it is important to identify a practice champion that will promote the use of aSBI within the practice. This person plays a crucial role both as a content resource related to aSBI techniques and as a role model and advocate for maintaining enthusiasm and sustainability within the office. The practice champion will also help identify and overcome any barriers that might get in the way of implementing or sustaining aSBI.
Next, evaluate the current patient flow in the...