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Raising achievement: educating physicians to address effects of at-risk drinking on common diseases

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Abstract:

Background: Despite a high prevalence, internists rarely screen for at-risk drinking. A contributing factor is likely to be physicians' limited understanding of the negative effects that at-risk drinking can have on common clinical conditions managed on a daily basis.

Objective: To develop and conduct a pre–post pilot evaluation of a web-based educational programme to educate and support physicians to assess alcohol use in patients with sleep disorders, depression and hypertension.

Methods: An expert panel developed a programme that addressed: 1) screening for alcohol use; 2) evidence on effect of alcohol on hypertension, sleep disorders and depression; 3) brief interventions for at-risk drinking with patient education materials; and 4) codes for payment of brief alcohol interventions. From an internist network, 17 physicians were recruited for a pilot test of the web-based educational programme. All participants were surveyed at baseline and at an end point three months after the intervention about attitudes, knowledge and beliefs about at-risk drinkers and effects of alcohol on hypertension, sleep disorders and depression.

Results: Among the 17 study physicians: 1) most believed that at-risk drinking affected their ability to treat hypertension, sleep disorders and depression (77% at baseline and 65% at end point); 2) nearly all were aware that at-risk drinking affects hypertension, sleep disorders and depression (94% at baseline and 94% at end point); and 3) 94% rated the educational programme positively at the end point. Frustration with managing at-risk alcohol use decreased (from 71% at baseline to 53% at end point) and study physicians' self-reported screening for at-risk drinking increased for new patients (from 47% at baseline to 71% at end point) and established patients (from 35% at baseline to 47% at end point).

Conclusion: This pilot of a web-based educational programme for internists was well received by study physicians. The programme increased screening for at-risk drinking while reducing frustration in dealing with this condition. Future work needs to evaluate this highly accessible programme in diverse practices and assess patient-related outcomes.

Keywords: AT-RISK DRINKING; COMMON CONDITIONS; WEB-BASED EDUCATION

Document Type: Short Communication

Affiliations: 1: Administrator, Clinical Policy, American College of Physicians, Department of Clinical Policy, Philadelphia, PA, USA 2: Director, Clinical Policy, American College of Physicians, Department of Clinical Policy, Philadelphia, PA, USA 3: Medical Director, Vaccines, Specialty Care Medicines Development Group, Pfizer Inc. Collegeville, PA, USA, American College of Physicians, Department of Clinical Policy, Philadelphia, PA, USA 4: Professor of Medicine, University of Pennsylvania, Philadelphia, PA, USA, American College of Physicians, Department of Clinical Policy, Philadelphia, PA, USA

Publication date: February 1, 2011

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