The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #67170

Kelly Vander Ley, PhD¹, Meg Hayes, MD², Chandra Lewis, MS¹, Jennifer Lembach, BA¹, Gillian Leichtling, BA¹, and Roy M. Gabriel, PhD¹. (1) RMC Research Corporation, 522 SW 5th Avenue, Suite 1407, Portland, OR 97204, (2) Department of Family Medicine, Oregon Health Science & University, 3181 SW Sam Jackson Park Road, Portland, OR 97219-3098

Project SPIRIT (Seeking Pathways Into Receiving Integrated Treatment) is a research project designed to document and demonstrate the effectiveness of integrated treatment approaches for treating persons with co-occurring disorders. One objective of this research was to increase physician recognition of substance problems in their patients and initiate discussions about appropriate treatment options. Several strategies including the development of a formalized referral system, physician trainings, physician consultations with a licensed professional counselor, and an e-mail notification system to alert physicians about at-risk patients were implemented and evaluated over an 18-month period. Data indicate that the e-mail notification system was the most effective strategy for engaging physicians and changing physician behavior in a short period of time. Through the physician e-mail notification system, a total of 466 contacts were made to 18 physicians/residents regarding 197 patients in 3 months. Of the 197 total patients, 176 were actually seen by the physician while 21 didn’t show for or cancelled their appointments. Overall, physicians addressed substance abuse with over 25% of the identified at-risk patients seen at the clinic (e.g., 48 of the 176 patients). Among the 18 physicians who participated in the study, 9 were responsible for 80% of the total times substance abuse was addressed with the patients. These 9 physicians addressed substance abuse with at least 50% of their patients about whom they were notified. In follow-up interviews, participating physicians and residents indicated that the e-mail notification system helped them to address substance abuse problems they would have not otherwise identified.

Learning Objectives:

At the conclusion of this session, participants will be able to
• Describe various strategies for increasing physician recognition of substance abuse problems in a primary care setting.
• Report on effectiveness of various strategies for engaging physicians in the importance of addressing substance abuse problems.
• Develop an e-mail notification system to alert physicians about substance abuse concerns in their treatment population.

Keywords: Substance Abuse, Primary Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.