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Alcohol, Smoking and Abuse
     Screening Project

               By
   Donna Clarke-McMullen, PHN
          Feb 19, 2007
Screening Project Outline

 Developed 1 page screen & resource
 package for primary care providers
 Piloted screen & resource package
 Academic detailing
 Pre-test questionnaire
 Post-test visits & questionnaire
 Evaluation results
Screening Project Objectives

 Identify “at-risk” women
 Primary care providers incorporate
 these tools into their practice
 Standardize Ask-Advise-Assist
 Evaluate clinical use of tool by
 primary care providers
 Assess detailing approach
Pre-test Resource Package

 Alcohol, smoking and abuse screens
 Backgrounders on T-ACE, Smoking
 Cessation & RUCS
 Related resource pamphlets
 Posters
 Resource order sheet
 Pre-test
Target Audience

                Total Visits Pre-test Post-test
Family
                178    137     56        32
physicians
Nurse
                 7      6       6         1
practitioners

Midwives         5      5       5         5

Total hcp       190    148     67        38
Pre-test Results
  It is appropriate to screen all my
  female patients.
             100%
                      8%
                              16%
             80%
Percentage
                                     33%
of health                                   Agree
             60%
care
providers             91%
                                            Strongly Agree
             40%              79%

                                     51%
             20%

              0%
                    Tobacco         Abuse
Pre-test Results
    I am comfortable asking my female
    patients about…
            100%     8%

                             21%
Percentage 80%
of health                                  Agree
care        60%
                                    36%
providers            93%
                                           Strongly Agree
            40%              73%


            20%                     36%


             0%
                   Tobacco         Abuse
Pre-test Screening Behaviour
   Screen 90+ % of female patients…
             100
                     87
             80
                               66
Percentage
             60
of health
care
             40
providers
             20                         14

              0
                   Tobacco   Alcohol   Abuse
Post-test Resource Package
 Pre-test results
 Brief Interventions Work
 Women Abuse is a Health Issue
 Article on intimate partner violence
 Article on brief intervention for alcohol
 problems
 Stages of change for smoking card
 Clinical Tobacco Intervention Bulletin
Post-test Response

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

 28% of hcp visited responded to the
 pre and post test
Screening Practices
    Percentage of health care providers
    who reported screening 90+ % of
    patients.
             100
                    87
              90
              80
              70             66 69
              60
Percentage                                       Pre-test
              50
              40                                 Post-test
                                            27
              30
              20                       14
              10
               0
                   Tobacco   Alcohol   Abuse
Tool Use
   Percentage of health care providers
   who used the tool or used the same
   questions.
           62     61

           60
                            58
           58

Percentage 56
                                     54
           54

           52

           50
                Tobacco   Alcohol   Abuse
Health Professionals Comments
 Just over half intend to use T-ACE
 (56%) and RUCS (54%)
 Increase in community program
 referrals
 Some really liked the tool
 Most didn’t want an extra piece of
 paper
 Anecdotally, some “at risk”
 identification stories shared
Academic Detailing

 Our experience
   66% found academic detailing useful
   66% read the resource package


 Lessons learned
Secondary Gains

 Promoted primary care providers
 resource catalogue
 Larson prenatal screen
 CPNP program using screens
 Increased resource requests
Q&A

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

  Donna Clarke-McMullen
dclarkemcmullen@healthunit.on.ca
Tel. 613-549-1232, ext. 529

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Tobacco,%20alcohol%20and%20abuse%20screening%20tool

  • 1. Alcohol, Smoking and Abuse Screening Project By Donna Clarke-McMullen, PHN Feb 19, 2007
  • 2. Screening Project Outline Developed 1 page screen & resource package for primary care providers Piloted screen & resource package Academic detailing Pre-test questionnaire Post-test visits & questionnaire Evaluation results
  • 3. Screening Project Objectives Identify “at-risk” women Primary care providers incorporate these tools into their practice Standardize Ask-Advise-Assist Evaluate clinical use of tool by primary care providers Assess detailing approach
  • 4. Pre-test Resource Package Alcohol, smoking and abuse screens Backgrounders on T-ACE, Smoking Cessation & RUCS Related resource pamphlets Posters Resource order sheet Pre-test
  • 5.
  • 6.
  • 7. Target Audience Total Visits Pre-test Post-test Family 178 137 56 32 physicians Nurse 7 6 6 1 practitioners Midwives 5 5 5 5 Total hcp 190 148 67 38
  • 8. Pre-test Results It is appropriate to screen all my female patients. 100% 8% 16% 80% Percentage 33% of health Agree 60% care providers 91% Strongly Agree 40% 79% 51% 20% 0% Tobacco Abuse
  • 9. Pre-test Results I am comfortable asking my female patients about… 100% 8% 21% Percentage 80% of health Agree care 60% 36% providers 93% Strongly Agree 40% 73% 20% 36% 0% Tobacco Abuse
  • 10. Pre-test Screening Behaviour Screen 90+ % of female patients… 100 87 80 66 Percentage 60 of health care 40 providers 20 14 0 Tobacco Alcohol Abuse
  • 11. Post-test Resource Package Pre-test results Brief Interventions Work Women Abuse is a Health Issue Article on intimate partner violence Article on brief intervention for alcohol problems Stages of change for smoking card Clinical Tobacco Intervention Bulletin
  • 12. Post-test Response 57% response rate from pre-test group Harder to visit the second time 28% of hcp visited responded to the pre and post test
  • 13. Screening Practices Percentage of health care providers who reported screening 90+ % of patients. 100 87 90 80 70 66 69 60 Percentage Pre-test 50 40 Post-test 27 30 20 14 10 0 Tobacco Alcohol Abuse
  • 14. Tool Use Percentage of health care providers who used the tool or used the same questions. 62 61 60 58 58 Percentage 56 54 54 52 50 Tobacco Alcohol Abuse
  • 15. Health Professionals Comments Just over half intend to use T-ACE (56%) and RUCS (54%) Increase in community program referrals Some really liked the tool Most didn’t want an extra piece of paper Anecdotally, some “at risk” identification stories shared
  • 16. Academic Detailing Our experience 66% found academic detailing useful 66% read the resource package Lessons learned
  • 17. Secondary Gains Promoted primary care providers resource catalogue Larson prenatal screen CPNP program using screens Increased resource requests
  • 18. Q&A www.healthunit.on.ca -”What’s New” section go to “Upcoming Events” Donna Clarke-McMullen dclarkemcmullen@healthunit.on.ca Tel. 613-549-1232, ext. 529