Referral to Treatment After Positive Screens for Unhealthy Drug Use in an Outpatient Veterans Administration Setting

Overview

Journal J Addict Med

Specialty Psychiatry

Date 2019 Oct 1

PMID 31567600

Citations 2

Authors

Dominic Hodgkin

Wenwu Gao

Mary Jo Larson

Charles E Drebing

Elizabeth L Merrick

Marianne Pugatch

Constance M Horgan

Galina Zolotusky

Nancy M Petry

Richard Saitz

Affiliations

Soon will be listed here.

Abstract

Objectives: To measure the rates and predictors of clinician recommendation for follow-up after a positive screen for unhealthy drug use, in a context of mandatory routine screening. To measure response to clinician recommendations and identification of new drug use diagnoses.

Methods: Data are from a Veterans Health Administration (VHA) medical center that introduced mandatory routine screening for unhealthy drug use in outpatient primary care and mental health settings, using a validated single question. This study analyzed VHA electronic health records data for patients who screened positive for unhealthy drug use (n = 570) and estimated logistic regression models to identify the predictors of receiving a recommendation for any follow-up and for specialty substance use disorder (SUD) treatment. Bivariate tests were used for other analyses.

Results: Among patients who screened positive for unhealthy drug use, 66% received no recommendation to return to primary care or another setting from the screening clinician. Further, among the 23% of patients who received a recommendation to visit specialty SUD treatment, only 25% completed the visit within 60 days. Six percent of all positive screens both received a referral to specialty SUD treatment and acted upon it.

Conclusions: In the context of mandatory drug use screening using a single item, rates of clinician action and patient receipt of care appeared low. Improved follow-up will require health systems to provide more supports for clinicians and patients at each of the stages from positive screen to attending the follow-up appointment.

Citing Articles

The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder.

J Addict Med. 2024; 18(1S Suppl 1):1-56.

PMID: 38669101 PMC: 11105801. DOI: 10.1097/ADM.0000000000001299.

Identification of the factors affecting the referral system of veterans' health services: A scoping review.

Taymournejad A, Hosseini S, Jafari M, Alimohammadzadeh K, Maher A J Educ Health Promot. 2023; 12:255.

PMID: 37727409 PMC: 10506785. DOI: 10.4103/jehp.jehp_69_23.

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