Telephone intervention screening reduces risky drinking in Texas study

Researchers at the University of Texas Dell School of Medicine at Austin successfully implemented a telephone-based screening and intervention program for unhealthy alcohol use in a large health center system. federal government in Texas. The study demonstrated significant reductions in alcohol consumption among a diverse adult patient population, including those insured through regional programs serving the otherwise uninsured or low-income.

Unhealthy alcohol consumption contributes to increased risks of multiple health problems, including liver disease, cardiovascular disease and various cancers. Recommendations for universal alcohol screening (recommended by the US 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 MedicineResearchers developed a multifaceted telecare program to provide brief interventions to patients with a positive screen.

The intervention included a two-session evidence-based counseling program administered by a bilingual counselor trained in social work. Patients identified as being at serious risk for alcohol use were offered pharmacotherapy and referred to addiction medicine services. Follow-up assessments were conducted after three to six months to assess changes in drinking habits.

A total of 3,959 patients were screened using the AUDIT-C questionnaire. Of these, 16% (632) tested positive for risky alcohol consumption. Patients most likely to screen positive included men, English speakers and those with commercial insurance. Researchers successfully engaged 412 patients and conducted comprehensive AUDIT assessments to determine the severity and risk levels of alcohol use.

Among engaged patients, 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. Of those with high initial AUDIT scores, 19 patients received pharmacotherapy and 13 used addiction medicine services.

Follow-up data were collected for 251 patients (61%). The results showed an average reduction in AUDIT score of 4.1 points (95% CI -3.4, -4.7). Spanish-speaking patients showed greater reductions than English speakers, with no significant differences observed between other demographic groups.

Patients with higher initial AUDIT scores (>12) experienced more substantial score decreases (mean reduction of 7.99) compared to those with moderate scores (mean decrease of 2.25).

The study illustrates that a telephone screening and brief intervention program can effectively reduce unhealthy alcohol use in a diverse patient population within a federally qualified health center. The approach also alleviated barriers to care, such as transportation and language, by providing bilingual and culturally competent services.

Researchers emphasize that while significant progress has been made, additional efforts are needed to increase drug therapy engagement, build provider capacity, and improve sustained patient follow-up, particularly for those with higher AUDIT scores. students.

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