Alcohol, Smoking and Abuse Screening Project

ByDonna Clarke-McMullen, PHN

Feb 19, 2007

Screening Project Outline

Developed 1 page screen & resource package for primary care providersPiloted screen & resource packageAcademic detailingPre-test questionnairePost-test visits & questionnaireEvaluation results

Screening Project Objectives

Identify “at-risk” womenPrimary care providers incorporate these tools into their practiceStandardize Ask-Advise-AssistEvaluate clinical use of tool by primary care providersAssess detailing approach

Pre-test Resource Package

Alcohol, smoking and abuse screensBackgrounders on T-ACE, Smoking Cessation & RUCSRelated resource pamphletsPostersResource order sheetPre-test

Target Audience

Total Visits Pre-test Post-test

Family physicians 178 137 56 32

Nurse practitioners 7 6 6 1

Midwives 5 5 5 5

Total hcp 190 148 67 38

Pre-test Results

91%79%

51%

8%16%

33%

0%

20%

40%

60%

80%

100%

Tobacco Abuse

Agree

Strongly Agree

Percentage of health care providers

It is appropriate to screen all my female patients.

Pre-test Results

93%

73%

36%

8%

21%

36%

0%

20%

40%

60%

80%

100%

Tobacco Abuse

Agree

Strongly Agree

Percentage of health care providers

I am comfortable asking my female patients about…

Pre-test Screening Behaviour

87

66

14

0

20

40

60

80

100

Tobacco Alcohol Abuse

Percentage of health care providers

Screen 90+ % of female patients…

Post-test Resource Package

Pre-test resultsBrief Interventions WorkWomen Abuse is a Health IssueArticle on intimate partner violenceArticle on brief intervention for alcohol problemsStages of change for smoking cardClinical Tobacco Intervention Bulletin

Post-test Response

57% response rate from pre-test groupHarder to visit the second time

28% of hcp visited responded to the pre and post test

Screening Practices

87

66

1427

69

0102030405060708090

100

Tobacco Alcohol Abuse

Pre-testPost-test

Percentage of health care providers who reported screening 90+ % of patients.

Percentage

Tool Use

61

58

54

50

52

54

56

58

60

62

Tobacco Alcohol Abuse

Percentage

Percentage of health care providers who used the tool or used the same questions.

Health Professionals Comments

Just over half intend to use T-ACE (56%) and RUCS (54%)Increase in community program referralsSome really liked the toolMost didn’t want an extra piece of paperAnecdotally, some “at risk” identification stories shared

Academic Detailing

Our experience66% found academic detailing useful66% read the resource package

Lessons learned

Secondary Gains

Promoted primary care providers resource catalogueLarson prenatal screenCPNP program using screensIncreased resource requests

Q & A

www.healthunit.on.ca-”What’s New” sectiongo to “Upcoming Events”

Donna Clarke-McMullendclarkemcmullen@healthunit.on.caTel. 613-549-1232, ext. 529