Interactive Voice Response Technology Can Deliver Alcohol Screening and Brief Intervention in Primary Care
- 167 Downloads
Alcohol screening and brief intervention (BI) is an effective primary care preventive service, but implementation rates are low. Automating BI using interactive voice response (IVR) may be an efficient way to expand patient access to needed information and advice.
To develop IVR-based BI and pilot test it for feasibility and acceptability.
Single-group pre-post feasibility study.
Primary care patients presenting for an office visit.
IVR-BI structured to correspond to the provider BI method recommended by NIAAA: (1) Ask about use; (2) Assess problems; (3) Advise and Assist for change, and (4) Follow up for continued support. Advice was tailored to patient readiness and preferences.
Utilization rate, call duration, and patients’ subjective reports of usefulness, comfort and honesty with the IVR-BI. Pre-post evaluation of motivation to change and change in alcohol consumption as measured by Timeline Follow Back.
Call duration ranged from 3–7 minutes. Subjective reactions were generally positive or neutral. About 40% of subjects indicated IVR-BI had motivated them to change. About half of the patients had discussed drinking with their provider at the visit. These tended to be heavier drinkers with greater concerns about drinking. Patients who reported a provider-delivered BI and called the IVR-BI endorsed greater comfort and honesty with the IVR-BI. On average, a 25% reduction in alcohol use was reported two weeks after the clinic visit.
Using IVR technology to deliver BI in a primary care setting is feasible and data suggest potential for efficacy in a larger trial.
KEY WORDSalcohol screening brief intervention primary care IVR technology
We gratefully acknowledge the assistance of Megan Malgeri in gathering the IVR-screen pre-test data.
We also would like to thank Dee Scheidel and all the staff at Given Essex for collaborating on this study.
This research was supported by NIAAA grant 1 R21 AA015777-01A1.
An abstract of this study was presented at a poster session at the Society of General Internal Medicine annual meeting, Miami, FL, May, 2009. This research was also presented as part of a symposium at the Research Society on Alcoholism annual meeting, San Diego, CA, June, 2009.
Conflict of Interest
- 2.US Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: recommendation statement. Ann Intern Med. 2004;140(7):554–6.Google Scholar
- 5.Kaner EF, Beyer F, Dickinson HO, et al. Effectiveness of brief alcohol interventions in primary care populations. [Review] [93 refs]. Cochrane Database Syst Rev. 2007;(2):CD004148.Google Scholar
- 8.National Center on Addiction and Substance Abuse (CASA). Missed opportunity: CASA national survey of primary care physicians and patients on substance abuse. New York: Columbia University; 2000.Google Scholar
- 28.Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. AUDIT-The alcohol use disorders identification test$ Guidelines for use in primary health care. 2nd ed. Geneva: World Health Organization; 2001.Google Scholar
- 29.National Institute of Alcohol and Alcohol Abuse. Helping Patients With Alcohol Problems: A Clinician’s Guide. Bethesda: NIH: the Institute; 2005.Google Scholar
- 31.Sobell LC, Sobell MB. Timeline follow-back: A technique for assessing self-reported alcohol consumption. In: Litten RZ, Allen JP, eds. Measuring alcohol consumption: Psychosocial and biochemical methods. Totowa: Humana Press; 1992:41–72.Google Scholar