期刊论文详细信息
BMC Family Practice
Impact of vital signs screening & clinician prompting on alcohol and tobacco screening and intervention rates: a pre-post intervention comparison
Research Article
John M Boltri1  J Paul Seale1  Monique Guyinn1  Monica Cornelius1  J Aaron Johnson1  Sylvia Shellenberger1  Dan Vinson2  Ike Okosun3  Mary M Velasquez4 
[1] Department of Family Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, 3780 Eisenhower Pkwy, 31206, Macon, GA, USA;Department of Family and Community Medicine, University of Missouri-Columbia, 65212, Columbia, MO, USA;Institute of Public Health, Georgia State University, 30302, Atlanta, GA, USA;School of Social Work, University of Texas-Austin, Austin, TX, USA;
关键词: Vital Sign;    Intervention Rate;    Alcohol Misuse;    Alcohol Intervention;    Tobacco Cessation;   
DOI  :  10.1186/1471-2296-11-18
 received in 2009-08-12, accepted in 2010-03-05,  发布年份 2010
来源: Springer
PDF
【 摘 要 】

BackgroundThough screening and intervention for alcohol and tobacco misuse are effective, primary care screening and intervention rates remain low. Previous studies have increased intervention rates using vital signs screening for tobacco misuse and clinician prompts for screen-positive patients for both alcohol and tobacco misuse. This pilot study's aims were: (1) To determine the feasibility of combined vital signs screening for tobacco and alcohol misuse, (2) To assess the impact of vital signs screening on alcohol and tobacco screening and intervention rates, and (3) To assess the additional impact of tobacco assessment prompts on intervention rates.MethodsIn five outpatient practices, nurses measuring vital signs were trained to routinely ask a single tobacco question, a prescreening question that identified current drinkers, and the single alcohol screening question for current drinkers. After 4-8 weeks, clinicians were trained in tobacco intervention and nurses were trained to give tobacco abusers a tobacco questionnaire which also served as a clinician intervention prompt. Screening and intervention rates were measured using patient exit interviews (n = 622) at baseline, during the "screening only" period, and during the tobacco prompting phase. Changes in screening and intervention rates were compared using chi square analyses and test of linear trends. Clinic staff were interviewed regarding patient and staff acceptability. Logistic regression was used to evaluate the impact of nurse screening on clinician intervention, the impact of alcohol intervention on concurrent tobacco intervention, and the impact of tobacco intervention on concurrent alcohol intervention.ResultsAlcohol and tobacco screening rates and alcohol intervention rates increased after implementing vital signs screening (p < .05). During the tobacco prompting phase, clinician intervention rates increased significantly for both alcohol (12.4%, p < .001) and tobacco (47.4%, p = .042). Screening by nurses was associated with clinician advice to reduce alcohol use (OR 13.1; 95% CI 6.2-27.6) and tobacco use (OR 2.6; 95% CI 1.3-5.2). Acceptability was high with nurses and patients.ConclusionsVital signs screening can be incorporated in primary care and increases alcohol screening and intervention rates. Tobacco assessment prompts increase both alcohol and tobacco interventions. These simple interventions show promise for dissemination in primary care settings.

【 授权许可】

CC BY   
© Seale et al; licensee BioMed Central Ltd. 2010

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