Systematic Implementation of Patient-centered Care for Alcohol Use Trial: Beyond Referral to Treatment

Kaiser Permanente1,500 enrolled

Overview

The Systematic Implementation of Patient-centered Care for Alcohol Use Trial is a pragmatic, cluster-randomized, effectiveness-implementation trial testing two interventions in Kaiser Permanente Washington to systematically implement shared decision-making with primary care patients with symptoms due to alcohol use: a primary care intervention and a centralized intervention. An anticipated 25 primary care clinics will be randomized to one of three conditions: usual care or the primary care or centralized interventions.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Enrollment

1,500

Conditions

Alcohol Use Disorder Unhealthy Alcohol Use

Interventions

Primary Care InterventionOTHER

A primary care intervention added to usual care that uses state-of-the-art implementation interventions to systematically encourage primary care providers to offer routine shared decision-making for symptoms due to alcohol use.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Adult primary care patients ≥18 years old on the day of a primary care appointment; and 2. ≥4 symptoms on the Alcohol Symptom Checklist, or 2-3 symptoms on the Alcohol Symptom Checklist with at least one symptom associated with high risk of progression to severe symptoms, documented in the electronic health record associated with the primary care appointment; and 3. high-risk drinking on the alcohol screening questionnaire (AUDIT-C ≥7) on the day of the Alcohol Symptom Checklist or in the prior 30 days documented in the electronic health record. Exclusion Criteria: 1. Documented request to not participate in research, or 2. Patient was eligible for the Vanguard pilot study.

Outcomes

Primary Outcomes

Documentation of alcohol or substance use disorder treatment in the electronic health record (including insurance claims).

Time frame: Treatment initiated up to 12 months.

Continuous measure of change in alcohol use as documented on the AUDIT-C screening questionnaire.

Time frame: Up to 24 months.

Central Contacts

Katharine Bradley, MD, MPH

CONTACT

206-948-1933 Katharine.A.Bradley@kp.org

Megan Addis