Project to Disseminate Alcohol, Drug and Depression Screening

Madison, Wisconsin - A new partnership will significantly expand dissemination of screening and intervention for alcohol abuse, drug abuse and depression in primary care clinics in Wisconsin and two other states.

The partnership, funded through a three-year, $3.5 million grant from the federal Agency for Healthcare Research and Quality, involves three regional health coalitions - the Pittsburgh Regional Health Initiative, the Institute for Clinical Systems Improvement in Minnesota and the Wisconsin Collaborative for Healthcare Quality (WCHQ).

The Wisconsin Collaborative for Healthcare Quality, whose members include University of Wisconsin Hospital and Clinics and the UW Medical Foundation, will partner with the Wisconsin Initiative to Promote Healthy Lifestyles (WIPHL), a national leader in screening and brief intervention programs for alcohol and drug abuse.

The Minnesota and Pittsburgh organizations are widely recognized as leaders in implementing similar programs targeting depression. All the programs are made available in primary care clinics.

The new partners will demonstrate how to spread and sustain better patient care in areas that typically have poor patient outcomes and significant health-care-system waste.

"The partners will help up to 90 primary care practices in Wisconsin, Minnesota and Pennsylvania implement behavioral health screening and early intervention," says Dr. Richard L. Brown, project director for the Wisconsin Initiative to Promote Healthy Lifestyles.

The Wisconsin Initiative to Promote Healthy Lifestyles is administered through the Department of Family Medicine (DFM) at the UW School of Medicine and Public Health and the Wisconsin Department of Health Services.

Assistance will include training practice teams, building patient and community awareness, developing patient registries to track patient progress and working with clinics and insurance companies to assure appropriate reimbursement, Brown says.

The Wisconsin Collaborative for Healthcare Quality will develop and implement quality measures among participating Wisconsin health plans to ensure effectiveness.

The Wisconsin Initiative to Promote Healthy Lifestyles has already implemented its Screening, Brief Intervention, Referral, and Treatment (SBIRT) services for alcohol and drug abuse at 21 sites across Wisconsin.

With the brief screening, each patient is asked four questions once a year during a routine clinic appointment. Patients who score positive meet with an on-site WIPHL-trained health educator who administers a longer set of questions indicating levels of risk and degree of the problem. The health educators interview patients who score positive and are at risk, helping many reduce their risky drinking.

The Screening, Brief Intervention, Referral, and Treatment program has its origins in research conducted by Brown and others in the DFM. The National Commission on Prevention Priorities has ranked SBIRT fourth among all preventive services for cost-effectiveness and prevention potential-higher than screening for high blood pressure, high cholesterol, diabetes and various cancers.

"We know that this simple screening is impacting patient drinking in a positive way," says Brown. "Expanding the program to a wider circle of clinics will clearly benefit many more patients."

The Wisconsin Initiative to Promote Healthy Lifestyles was funded in 2007 with a $12.6 million grant from the federal Substance Abuse and Mental Health Services Administration.