Date of Presentation

5-4-2023 12:00 AM

College

School of Osteopathic Medicine

Poster Abstract

Background and Purpose: Implementing the SBIRT model for substance use in a primary care setting has many benefits including normalizing conversations about alcohol and other substance use into patients’ visits, thereby reducing harm, reducing consumption and its negative impact, and promoting system changes to overcome barriers to treatment access. The full scope of the current SBIRT project involves the recruitment, hiring, training, and integration of health educators in 9 primary care sites throughout South Jersey, as well as a project supervisor serving as implementation lead and liaison to medical and administrative staff at all 9 primary care sites. Initial barriers to implementation within sites included challenges regarding work-flow between providers, CMA’s, and health educators (integration-of-care challenges between allied health professionals from varying disciplines); and variations in administrative processes across 9 different primary care settings serving diverse patient demographics. Challenges to implementation with personnel included unexpected loss of key project personnel and changeover in project leadership. Additionally, legalization of medical and recreational cannabis in the state of New Jersey has made implementation of the grant (as written) challenging, as cannabis remains a Schedule 1 substance at the federal level and is included in the writing of this federally funded grant as an illicit substance. Due to Covid, a decrease of in-person visits in primary care settings as well as the normalization of telehealth visits have challenged the Health Educators’ ability to see potential pre-screen-positive patients. This lower volume of in-person patients has also subsequently resulted in more efficient processing of patient visits, affording less time to incorporate health education and brief intervention within each patient visit. There is a distinct need to develop a protocol for intervention with telehealth patients who screen positive for SBIRT services. Strategies for addressing these challenges, future directions of the project, and lessons learned will also be presented.

References: Kamath, C. C., Kelpin, S. S., Patten, C. A., Rummans, T. A., Kremers, H. M., Oesterle, T. S., Williams, M. D., & Breitinger, S. A. (2022). Shaping the Screening, Behavioral Intervention, and Referral to Treatment (SBIRT) Model for Treatment of Alcohol Use Disorder in the COVID-19 Era. In Mayo Clinic Proceedings (Vol. 97, Issue 10, pp. 1774–1779). Elsevier Ltd. https://doi.org/10.1016/j.mayocp.2022.07.006 Substance Abuse Overview 2021 Statewide - NJ.GOV. (n.d.). Retrieved April 18, 2023, from https://nj.gov/humanservices/dmhas/publications/statistical/Substance%20Abuse%20Overview/2021/statewide.pd Moore, Ramey PhDa; Purvis, Rachel S. PhDa; Hallgren, Emily PhDa; Reece, Sharon MD, CCFPa; Padilla-Ramos, Alan MDa; Gurel-Headley, Morgan BSb,c; Hall, Spencer MAd; McElfish, Pearl A. PhD, MBAa,*. “I am hesitant to visit the doctor unless absolutely necessary”: A qualitative study of delayed care, avoidance of care, and telehealth experiences during the COVID-19 pandemic. Medicine 101(32):p e29439, August 12, 2022. | DOI: 10.1097/MD.0000000000029439

Keywords

Primary Health Care, Implementing SBIRT, Substance-Related Disorders

Disciplines

Community Health and Preventive Medicine | Health and Medical Administration | Health Information Technology | Medicine and Health Sciences | Patient Safety | Primary Care | Public Health Education and Promotion | Substance Abuse and Addiction

Document Type

Poster

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May 4th, 12:00 AM

Challenges to Implementing Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Substance Use in Primary Care Settings at Rowan-Virtua

Background and Purpose: Implementing the SBIRT model for substance use in a primary care setting has many benefits including normalizing conversations about alcohol and other substance use into patients’ visits, thereby reducing harm, reducing consumption and its negative impact, and promoting system changes to overcome barriers to treatment access. The full scope of the current SBIRT project involves the recruitment, hiring, training, and integration of health educators in 9 primary care sites throughout South Jersey, as well as a project supervisor serving as implementation lead and liaison to medical and administrative staff at all 9 primary care sites. Initial barriers to implementation within sites included challenges regarding work-flow between providers, CMA’s, and health educators (integration-of-care challenges between allied health professionals from varying disciplines); and variations in administrative processes across 9 different primary care settings serving diverse patient demographics. Challenges to implementation with personnel included unexpected loss of key project personnel and changeover in project leadership. Additionally, legalization of medical and recreational cannabis in the state of New Jersey has made implementation of the grant (as written) challenging, as cannabis remains a Schedule 1 substance at the federal level and is included in the writing of this federally funded grant as an illicit substance. Due to Covid, a decrease of in-person visits in primary care settings as well as the normalization of telehealth visits have challenged the Health Educators’ ability to see potential pre-screen-positive patients. This lower volume of in-person patients has also subsequently resulted in more efficient processing of patient visits, affording less time to incorporate health education and brief intervention within each patient visit. There is a distinct need to develop a protocol for intervention with telehealth patients who screen positive for SBIRT services. Strategies for addressing these challenges, future directions of the project, and lessons learned will also be presented.

References: Kamath, C. C., Kelpin, S. S., Patten, C. A., Rummans, T. A., Kremers, H. M., Oesterle, T. S., Williams, M. D., & Breitinger, S. A. (2022). Shaping the Screening, Behavioral Intervention, and Referral to Treatment (SBIRT) Model for Treatment of Alcohol Use Disorder in the COVID-19 Era. In Mayo Clinic Proceedings (Vol. 97, Issue 10, pp. 1774–1779). Elsevier Ltd. https://doi.org/10.1016/j.mayocp.2022.07.006 Substance Abuse Overview 2021 Statewide - NJ.GOV. (n.d.). Retrieved April 18, 2023, from https://nj.gov/humanservices/dmhas/publications/statistical/Substance%20Abuse%20Overview/2021/statewide.pd Moore, Ramey PhDa; Purvis, Rachel S. PhDa; Hallgren, Emily PhDa; Reece, Sharon MD, CCFPa; Padilla-Ramos, Alan MDa; Gurel-Headley, Morgan BSb,c; Hall, Spencer MAd; McElfish, Pearl A. PhD, MBAa,*. “I am hesitant to visit the doctor unless absolutely necessary”: A qualitative study of delayed care, avoidance of care, and telehealth experiences during the COVID-19 pandemic. Medicine 101(32):p e29439, August 12, 2022. | DOI: 10.1097/MD.0000000000029439

 

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