Efficacy of IVR-Based Brief Intervention for Alcohol Problems
1University of Vermont
Journal MTM 1:4S:5, 2012
Alcohol screening and brief intervention (SBI) is a clinical approach to reducing alcohol consumption and harms whose efficacy is well established. In spite of empirical support for the intervention, and its endorsement by entities such as the National Institutes of Health (NIH) and the US Preventive Services Task Force, implementation in clinical settings is limited. Delivery of SBI to heavy drinkers may be expanded with technology.
We developed an Interactive Voice Response (IVR) system that delivers Brief Intervention (BI) according to NIH clinician’s guidelines. Pilot studies supported feasibility, and now we are evaluating efficacy with a randomized, controlled trial. Objectives are threefold: evaluate the efficacy of IVR-BI for reducing drinking; determine the impact of IVR-BI on patient-physician interaction; and determine patient characteristics associated with treatment effect.
Patients presenting to primary care clinics are called by research staff three days before their appointment and asked to participate. Consenting patients are transferred to IVR for a brief behavioralhealth screening questionnaire (IVR-Screen), the results of which are automatically routed to their electronic medical record (EMR). Participants drinking above NIH guidelines for low-risk drinking qualify for the IVR-BI; consenting patients are randomized immediately and either complete or do not complete the IVR-BI. Participants are interviewed by research staff after their health care visit and again 3- and 6-months later.
To date, 21 have been randomized to IVR-BI vs. usual care, with follow-up interviews pending. Interviews will assess participants’ alcohol-related conversations with their primary care providers, their drinking behavior, and any treatment experiences they have had. Results of 3-month interview data on an anticipated 300 participants will be available for presentation at the time of the mHealth summit. The future potential of this IVR-EMR integrated system for delivering health screening and education relates not only to alcohol but to other behavioral problems as well.