New article by Sarah Scholle

Health Affairs recently published an article by a team including Sarah H. Scholle, DrPH. In addition to serving as Vice President of the National Committee for Quality Assurance, in Washington, D.C., Sarah is a co-investigator on IBH-PC.

Health Aff (Millwood). 2016 Jun 1;35(6):1000-1008.

Quality Measures For Mental Health And Substance Use: Gaps, Opportunities, And Challenges.

Pincus HA1, Scholle SH2, Spaeth-Rublee B3, Hepner KA4, Brown J5.

Author information

Abstract

Following up on its Crossing the Quality Chasm report, in 2006 the Institute of Medicine issued a report that included sweeping recommendations to improve the quality of behavioral health care in the United States. To date, few of those recommendations have been implemented, and there is little evidence that behavioral health care quality has improved significantly over the past ten years. However, the advent of health care reform, parity of insurance coverage, and growing recognition of the impact of behavioral health disorders on population health and health care costs have created new demands and opportunities for expanded and innovative strategies to assess the quality of care for this patient population. We provide an overview of the current state of quality measurement in behavioral health, identify key priorities for measure development, and describe the most important challenges. We recommend a coordinated plan that would boost investment in developing, evaluating, and implementing behavioral health quality measures; conduct research to develop the evidence necessary to support a more robust set of measures; overcome barriers to the improvement and linking of data sources; and expand efforts to build the capacity of the clinical workforce, in partnership with consumers, to improve quality.

The full article is available here.

Co-investigator Jen Lavoie is also an artist

When she is not a patient co-investigator managing the stakeholder engagement activities of IBH-PC, Jen Lavoie is a highly-regarded fiber artist. In fact, many in the special field of hooked-rug art consider her the best practitioner working today! One of her latest rugs is mentioned here and is part of a show of hand-hooked rugs depicting the Tarot.

Congrats to Jen on another beautiful creation!

Tarot #8 "Strength", by Jennifer O'Rourke Lavoie

New publication by IBH-PC's Gail Rose

Gail Rose, PhD, Associate Project Director, just published this work from her "other life" where she develops and evaluates new ways to help people with unhealthy drinking.

J Gen Intern Med. 2016 May 20. [Epub ahead of print]

A Randomized Controlled Trial of IVR-Based Alcohol Brief Intervention to Promote Patient-Provider Communication in Primary Care.

Rose GL1, Badger GJ2, Skelly JM2, Ferraro TA3, MacLean CD4, Helzer JE5.

Author information

Abstract

BACKGROUND:

Brief interventions for unhealthy drinking in primary care settings are efficacious, but underutilized. Efforts to improve rates of brief intervention though provider education and office systems redesign have had limited impact. Our novel brief intervention uses interactive voice response (IVR) to provide information and advice directly to unhealthy drinkers before a physician office visit, with the goals of stimulating in-office dialogue about drinking and decreasing unhealthy drinking. This automated approach is potentially scalable for wide application.

OBJECTIVE:

We aimed to examine the effect of a pre-visit IVR-delivered brief alcohol intervention (IVR-BI) on patient-provider discussions of alcohol during the visit.

DESIGN:

This was a parallel group randomized controlled trial with two treatment arms: 1) IVR-BI or 2) usual care (no IVR-BI).

PARTICIPANTS:

In all, 1,567 patients were recruited from eight university medical center-affiliated internal medicine and family medicine clinics.

INTERVENTIONS:

IVR-BI is a brief alcohol intervention delivered by automated telephone. It has four components, based on the intervention steps outlined in the National Institute of Alcohol Abuse and Alcoholism guidelines for clinicians: 1) ask about alcohol use, 2) assess for alcohol use disorders, 3) advise patient to cut down or quit drinking, and 4) follow up at subsequent visits.

MAIN MEASURES:

Outcomes were patient reported: patient-provider discussion of alcohol during the visit; patient initiation of the discussion; and provider's recommendation about the patient's alcohol use.

KEY RESULTS:

Patients randomized to IVR-BI were more likely to have reported discussing alcohol with their provider (52 % vs. 44 %, p = 0.003), bringing up the topic themselves (20 % vs. 12 %, p < 0.001), and receiving a recommendation (20 % vs. 14 %, p < 0.001). Other predictors of outcome included baseline consumption, education, age, and alcohol use disorder diagnosis.

CONCLUSIONS:

Providing automated brief interventions to patients prior to a primary care visit promotes discussion about unhealthy drinking and increases specific professional advice regarding changing drinking behavior.

- Ben Littenberg