From 2006 to 2010, risky and excessive alcohol use in the United States caused about 88,000 deaths.
Family physicians are well-positioned to help prevent morbidity and mortality associated with risky alcohol use. To support their efforts, the AAFP has added the newly released Addressing Alcohol Use Practice Manual: An Alcohol Screening and Brief Intervention Program(466 KB PDF) to its collection of resources to combat alcohol misuse.
Created through a partnership between the AAFP and the Baylor College of Medicine Practice and Implementation Center, the manual was supported by funding from the CDC.
AAFP member Roger Zoorob, M.D., M.P.H., Richard M. Kleberg Sr. Professor and Chair of the Department of Family and Community Medicine at Baylor College of Medicine, oversaw the project. Zoorob told AAFP News that he's been working with the CDC on alcohol screening and brief intervention (SBI) for the past 10 years and is pleased to see that Baylor is now collaborating with the AAFP in this area.
- The AAFP has partnered with Baylor College of Medicine in Houston to create a new alcohol screening and brief intervention manual for family medicine practices.
- Roger Zoorob, M.D., M.P.H., professor and family medicine chair at the college, said the manual not only makes the case that family physicians should buy in to alcohol screening and brief intervention, but also guides them step-by-step through the screening and intervention process and how to implement it in practice.
- The manual, Addressing Alcohol Use Practice Manual: An Alcohol Screening and Brief Intervention Program, specifically addresses topics such as identifying champions to promote alcohol screening and brief intervention, and implementing risky drinking registries.
"This combination is more than additive and will help us spread the message together and in partnership with the CDC, especially in the realm of alcohol screening and brief intervention in the family physician's office."
Zoorob said the manual not only makes the case that family physicians should buy in to alcohol screening and brief intervention, but also guides them step-by-step through the screening and intervention process and how to implement it in practice. Additionally, it addresses barriers to implementation and how to select and work with office champions to implement the process.
"The manual can be used as a stand-alone document for reference or can supplement training we provide for practices to implement alcohol screening and brief intervention in the family physician's office," he said. (See sidebar below.)
The manual is divided into sections that address how to
- identify office champions who can promote alcohol SBI;
- evaluate an office's current system for alcohol screening and intervention;
- define a new system for alcohol screening and intervention; and
- standardize the new screening system using electronic health records for coding, implementing risky drinking registries and creating a feedback mechanism to tweak the system.
Additional sections offer advice on addressing resistance to change in the office and a printable form to use as a starting point for an implementation plan. The guide also offers more resources for alcohol screening and intervention, including other training opportunities.
Screening for Alcohol Use During Visits
Zoorob said family physicians should use every visit to address patients' alcohol intake using validated questionnaires and tools. He also noted that this process of identifying alcohol misuse is different than identifying addiction.
Training Opportunity on Using Alcohol Screening Manual
Baylor College of Medicine's Practice and Implementation Center is offering family medicine practices a training opportunity(44 KB PDF) to learn how to implement its new Addressing Alcohol Use Practice Manual: An Alcohol Screening and Brief Intervention Program(466 KB PDF) that represents a partnership with the AAFP supported by the CDC.
"We are looking for potential mid-size practices with four to 10 family physicians who are willing to train and get their staff trained to implement the alcohol screening and brief intervention program in their practices," said AAFP member Roger Zoorob, M.D., M.P.H., a professor and chair of family medicine at the Baylor College of Medicine.
Training is available in-person and will also be offered as online modules with free CME credit in collaboration with the CDC.
To join the project, family physicians are invited to contact Katherine Thomas, M.P.H., senior project coordinator, at 713-798-1369 or via email.
"The family medicine office is the ideal place to address this common problem," he said. "I would like to emphasize that alcohol use and misuse are extremely prevalent. Our patients don't have to abuse alcohol to have bad effects."
For example, Zoorob said alcohol misuse can result in short- and long-term side effects and complications including domestic violence, motor vehicle accidents, liver disease, cancer of various organs, pancreatitis, reflux disease and gastritis.
"Women of childbearing age are at highest risk for any alcohol intake due to the effect on the baby with any potential pregnancy," he said. These risks can include pregnancy complications such as preterm labor and a spectrum of disorders called fetal alcohol spectrum disorders that manifest as behavioral and growth problems in affected infants.
"It's our hope that through this manual and other training programs planned thorough partnership with the CDC and the AAFP, we can disseminate evidence-based training and knowledge and implement routine screening and brief intervention for alcohol misuse in every family practice in the United States," Zoorob concluded.
Additional AAFP Resources
The AAFP offers additional resources on alcohol misuse, including a clinical preventive service recommendation, a preconception care position paper and various CME opportunities.
Related AAFP News Coverage
Leader Voices Blog: Screen for Alcohol Abuse During Holiday Season