Documented brief intervention not associated with resolution of unhealthy alcohol use one year later among VA patients living with HIV

Emily C. Williams, Gwen T. Lapham, Jennifer F. Bobb, Anna D. Rubinsky, Sheryl L Catz, Susan M. Shortreed, Kara M. Bensley, Katharine A. Bradley

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective Unhealthy alcohol use is particularly risky for patients living with HIV (PLWH). Brief interventions reduce drinking among patients with unhealthy alcohol use, but whether its receipt in routine outpatient settings is associated with reduced drinking among PLWH with unhealthy alcohol use is unknown. We assessed whether PLWH who screened positive for unhealthy alcohol use were more likely to resolve unhealthy drinking one year later if they had brief alcohol intervention (BI) documented in their electronic health record in a national sample of PLWH from the Veterans Health Administration. Methods Secondary VA clinical and administrative data from the electronic medical record (EMR) were used to identify all positive alcohol screens (AUDIT-C score ≥ 5) documented among PLWH (10/01/09-5/30/13) followed by another alcohol screen documented 9–15 months later. Unadjusted and adjusted Poisson regression models assessed the association between brief intervention (advice to reduce drinking or abstain documented in EMR) and resolution of unhealthy alcohol use (follow-up AUDIT-C < 5 with ≥ 2 point reduction). Results Overall 2101 PLWH with unhealthy drinking (10/01/09-5/30/13) had repeat alcohol screens 9–15 months later. Of those, 77% had brief intervention documented after their first screen, and 61% resolved unhealthy alcohol use at follow-up. Documented brief intervention was not associated with resolution [Adjusted incidence rate ratio 0.96, (95% CI 0.90–1.02)]. Conclusions Documented brief intervention was not associated with resolving unhealthy alcohol use at follow-up screening among VA PLWH with unhealthy alcohol use. Effective methods of resolving unhealthy alcohol use in this vulnerable population are needed.

Original languageEnglish (US)
Pages (from-to)8-14
Number of pages7
JournalJournal of Substance Abuse Treatment
Volume78
DOIs
StatePublished - Jul 1 2017

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Alcohols
HIV
Drinking
Electronic Health Records
Veterans Health
United States Department of Veterans Affairs
Vulnerable Populations
Outpatients
Incidence

Keywords

  • Alcohol
  • Brief intervention
  • HIV
  • Unhealthy alcohol use

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Phychiatric Mental Health
  • Clinical Psychology
  • Psychiatry and Mental health

Cite this

Documented brief intervention not associated with resolution of unhealthy alcohol use one year later among VA patients living with HIV. / Williams, Emily C.; Lapham, Gwen T.; Bobb, Jennifer F.; Rubinsky, Anna D.; Catz, Sheryl L; Shortreed, Susan M.; Bensley, Kara M.; Bradley, Katharine A.

In: Journal of Substance Abuse Treatment, Vol. 78, 01.07.2017, p. 8-14.

Research output: Contribution to journalArticle

Williams, Emily C. ; Lapham, Gwen T. ; Bobb, Jennifer F. ; Rubinsky, Anna D. ; Catz, Sheryl L ; Shortreed, Susan M. ; Bensley, Kara M. ; Bradley, Katharine A. / Documented brief intervention not associated with resolution of unhealthy alcohol use one year later among VA patients living with HIV. In: Journal of Substance Abuse Treatment. 2017 ; Vol. 78. pp. 8-14.
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abstract = "Objective Unhealthy alcohol use is particularly risky for patients living with HIV (PLWH). Brief interventions reduce drinking among patients with unhealthy alcohol use, but whether its receipt in routine outpatient settings is associated with reduced drinking among PLWH with unhealthy alcohol use is unknown. We assessed whether PLWH who screened positive for unhealthy alcohol use were more likely to resolve unhealthy drinking one year later if they had brief alcohol intervention (BI) documented in their electronic health record in a national sample of PLWH from the Veterans Health Administration. Methods Secondary VA clinical and administrative data from the electronic medical record (EMR) were used to identify all positive alcohol screens (AUDIT-C score ≥ 5) documented among PLWH (10/01/09-5/30/13) followed by another alcohol screen documented 9–15 months later. Unadjusted and adjusted Poisson regression models assessed the association between brief intervention (advice to reduce drinking or abstain documented in EMR) and resolution of unhealthy alcohol use (follow-up AUDIT-C < 5 with ≥ 2 point reduction). Results Overall 2101 PLWH with unhealthy drinking (10/01/09-5/30/13) had repeat alcohol screens 9–15 months later. Of those, 77{\%} had brief intervention documented after their first screen, and 61{\%} resolved unhealthy alcohol use at follow-up. Documented brief intervention was not associated with resolution [Adjusted incidence rate ratio 0.96, (95{\%} CI 0.90–1.02)]. Conclusions Documented brief intervention was not associated with resolving unhealthy alcohol use at follow-up screening among VA PLWH with unhealthy alcohol use. Effective methods of resolving unhealthy alcohol use in this vulnerable population are needed.",
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AU - Lapham, Gwen T.

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AU - Shortreed, Susan M.

AU - Bensley, Kara M.

AU - Bradley, Katharine A.

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N2 - Objective Unhealthy alcohol use is particularly risky for patients living with HIV (PLWH). Brief interventions reduce drinking among patients with unhealthy alcohol use, but whether its receipt in routine outpatient settings is associated with reduced drinking among PLWH with unhealthy alcohol use is unknown. We assessed whether PLWH who screened positive for unhealthy alcohol use were more likely to resolve unhealthy drinking one year later if they had brief alcohol intervention (BI) documented in their electronic health record in a national sample of PLWH from the Veterans Health Administration. Methods Secondary VA clinical and administrative data from the electronic medical record (EMR) were used to identify all positive alcohol screens (AUDIT-C score ≥ 5) documented among PLWH (10/01/09-5/30/13) followed by another alcohol screen documented 9–15 months later. Unadjusted and adjusted Poisson regression models assessed the association between brief intervention (advice to reduce drinking or abstain documented in EMR) and resolution of unhealthy alcohol use (follow-up AUDIT-C < 5 with ≥ 2 point reduction). Results Overall 2101 PLWH with unhealthy drinking (10/01/09-5/30/13) had repeat alcohol screens 9–15 months later. Of those, 77% had brief intervention documented after their first screen, and 61% resolved unhealthy alcohol use at follow-up. Documented brief intervention was not associated with resolution [Adjusted incidence rate ratio 0.96, (95% CI 0.90–1.02)]. Conclusions Documented brief intervention was not associated with resolving unhealthy alcohol use at follow-up screening among VA PLWH with unhealthy alcohol use. Effective methods of resolving unhealthy alcohol use in this vulnerable population are needed.

AB - Objective Unhealthy alcohol use is particularly risky for patients living with HIV (PLWH). Brief interventions reduce drinking among patients with unhealthy alcohol use, but whether its receipt in routine outpatient settings is associated with reduced drinking among PLWH with unhealthy alcohol use is unknown. We assessed whether PLWH who screened positive for unhealthy alcohol use were more likely to resolve unhealthy drinking one year later if they had brief alcohol intervention (BI) documented in their electronic health record in a national sample of PLWH from the Veterans Health Administration. Methods Secondary VA clinical and administrative data from the electronic medical record (EMR) were used to identify all positive alcohol screens (AUDIT-C score ≥ 5) documented among PLWH (10/01/09-5/30/13) followed by another alcohol screen documented 9–15 months later. Unadjusted and adjusted Poisson regression models assessed the association between brief intervention (advice to reduce drinking or abstain documented in EMR) and resolution of unhealthy alcohol use (follow-up AUDIT-C < 5 with ≥ 2 point reduction). Results Overall 2101 PLWH with unhealthy drinking (10/01/09-5/30/13) had repeat alcohol screens 9–15 months later. Of those, 77% had brief intervention documented after their first screen, and 61% resolved unhealthy alcohol use at follow-up. Documented brief intervention was not associated with resolution [Adjusted incidence rate ratio 0.96, (95% CI 0.90–1.02)]. Conclusions Documented brief intervention was not associated with resolving unhealthy alcohol use at follow-up screening among VA PLWH with unhealthy alcohol use. Effective methods of resolving unhealthy alcohol use in this vulnerable population are needed.

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