Implementation and Quality Improvement of a Screening and Counseling Program for Unhealthy Alcohol Use in an Academic General Internal Medicine Practice.

Journal Article (Journal Article)

Unhealthy alcohol use is the third leading cause of preventable death in the United States. The U.S. Preventive Services Task Force (USPSTF) recommends screening for unhealthy alcohol use but little is known about how best to do so. We used quality improvement techniques to implement a systematic approach to screening and counseling primary care patients for unhealthy alcohol use. Components included use of validated screening and assessment instruments; an evidence-based two-visit counseling intervention using motivational interviewing techniques for those with risky drinking behaviors who did not have an alcohol use disorder (AUD); shared decision making about treatment options for those with an AUD; support materials for providers and patients; and training in motivational interviewing for faculty and residents. Over the course of one year, we screened 52% (N = 5,352) of our clinic's patients and identified 294 with positive screens. Of those 294, appropriate screening-related assessments and interventions were documented for 168 and 72 patients, respectively. Although we successfully implemented a systematic screening program and structured processes of care, ongoing quality improvement efforts are needed to screen the rest of our patients and to improve the consistency with which we provide and document appropriate interventions.

Full Text

Duke Authors

Cited Authors

  • Jonas, DE; Miller, T; Ratner, S; McGuirt, B; Golin, CE; Grodensky, C; Sturkie, E; Kinley, J; Dale, M; Pignone, M

Published Date

  • January 2017

Published In

Volume / Issue

  • 39 / 1

Start / End Page

  • 15 - 27

PubMed ID

  • 28045764

Pubmed Central ID

  • PMC5213337

Electronic International Standard Serial Number (EISSN)

  • 1945-1474

International Standard Serial Number (ISSN)

  • 1062-2551

Digital Object Identifier (DOI)

  • 10.1097/jhq.0000000000000069


  • eng