SHM Converge Scientific Abstract ePoster Gallery-Screening and Treatment of Unhealthy Alcohol Use During Acute Hospitalization

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This project describes a hospital-based Screening, Brief Intervention, and Referral to Treatment (SBIRT) program for unhealthy alcohol use (UAU) and alcohol use disorder (AUD) at a safety-net hospital in Austin, Texas. The goal was to address major under-screening and undertreatment, since most patients nationally are not identified or treated despite evidence that screening, brief intervention, and medications for AUD (MAUD) reduce alcohol use.<br /><br />The protocol was carried out by substance use navigator social workers (SUNs). Hospital nurses first administered the AUDIT-PC screen. Patients who screened positive received a full AUDIT, motivational interviewing, and, when appropriate, medication initiation. SUNs also arranged follow-up appointments, provided referrals, and coordinated post-discharge care.<br /><br />In the first 18 months (September 2022 to February 2024), 13,082 hospitalized patients were screened. Of these, 754 (5.76%) had a positive screen and were eligible for intervention. The most common characteristics among these patients were male sex, age 45–64, White or Hispanic ethnicity, housed or temporarily housed status, and lack of insurance. Notably, 58.8% were admitted because of alcohol use.<br /><br />Of the 754 eligible patients, 536 received the intervention. Among those, 233 were eligible for and interested in MAUD, and 214 started medication. Follow-up data were available for 92 patients by phone at 4–6 weeks; 57 attended an outpatient appointment, 27 were adherent to pharmacotherapy, and 72 completed a repeat AUDIT. Among those with repeat AUDITs, 60 had lower scores and 12 were unchanged or worse. The mean AUDIT score change was -12.5.<br /><br />Overall, the program shows that inpatient SBIRT with navigator support can identify many patients with alcohol-related needs, start treatment during hospitalization, and reduce alcohol use after discharge. Future work should improve long-term engagement and outcome tracking.

Asset Subtitle

Jananie Ramesh

Meta Tag

Author List Alanna Boulton, Christopher Moriates, Frances J. Ibarra, Jananie Ramesh, Kirk Von Sternberg, Mary Velasquez, Michael Pignone, Nicole Kluz, Ohenewaa Dede-Bamfo, Rachel Holliman

Category Innovations

Concept SBIRT

Concept Unhealthy Alcohol Use

Concept Screening

Concept Brief Intervention

Concept Referral to Treatment

Distinguished Non-Finalist

Presenter Organization Dell Medical School at the University of Texas at Austin

Presenting Author Jananie Ramesh

Track Quality Improvement

Keywords

SBIRT

unhealthy alcohol use

alcohol use disorder

hospital screening

brief intervention

motivational interviewing

medication for AUD

substance use navigator

safety-net hospital

Austin Texas

SBIRT

Unhealthy Alcohol Use

Screening

Brief Intervention

Referral to Treatment