Evidence map›Paper›PMID 29595402›Full record

ArticleSubstance abuse2018

Implementing single-item screening for drug use in a Veterans Health Administration outpatient setting.

Dominic Hodgkin, Wenwu Gao, Elizabeth L Merrick, Charles E Drebing, Mary Jo Larson, Constance M Horgan, Monica Sharma, Nancy M Petry, Richard Saitz

Abstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Substance abuse, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Dominic Hodgkina Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University , Waltham , Massachusetts , USA.
Wenwu Gaob Psychology Service , Bedford Department of Veterans Affairs Medical Center , Bedford , Massachusetts , USA.
Elizabeth L Merricka Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University , Waltham , Massachusetts , USA.
Charles E Drebingb Psychology Service , Bedford Department of Veterans Affairs Medical Center , Bedford , Massachusetts , USA.
Mary Jo Larsona Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University , Waltham , Massachusetts , USA.
Constance M Horgana Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and Management, Brandeis University , Waltham , Massachusetts , USA.
Monica Sharmac Primary Care Service , Bedford Department of Veterans Affairs Medical Center , Bedford , Massachusetts , USA.
Nancy M Petryd Department of Psychiatry , University of Connecticut School of Medicine , Farmington , Connecticut , USA.
Richard Saitze Department of Community Health Sciences , Boston University School of Public Health , Boston , Massachusetts , USA.
Brandeis University · USEdith Nourse Rogers Memorial Veterans Hospital · USBoston University · USUniversity of Connecticut · US

Funding

Enhancing Early-Phase Care for Primary Care Patients with Unhealthy Substance UseR21DA032039 · NIDA · BRANDEIS UNIVERSITY · PI HODGKIN, DOMINIC · 2012 to 2013
$405k
NIDA NIH HHS R21 DA032039
6 · The paper itself

Abstract

backgroundUnhealthy drug use is a concern in many settings, including military and veteran populations. In 2013, the Veterans Health Administration (VHA) medical center in Bedford, Massachusetts, started requiring routine screening for unhealthy drug use in outpatient primary care and mental health settings, using a validated single question.

methodsThis study used descriptive and multivariable analyses of VHA electronic records for patients eligible for the screening program (N = 16,118). The study assessed first-year rates and predictors of screening and of positive screens, both for drug use and for unhealthy alcohol use, for which screening was already required.

resultsDuring the first year, 70% of patients were screened for unhealthy drug use and 84% were screened for unhealthy alcohol use. In multivariable analyses, screening for drug use was more likely for patients who had 8 or more days with VHA visits or were aged 40 or over. Patients with a prior drug use disorder diagnosis were much less likely to be screened. Three percent of patients screened for unhealthy drug use had a positive screen, and 14% of those screened for unhealthy alcohol use had a positive screen. Strong predictors of a positive drug use screen included a prior-year diagnosis of drug use disorder, any mental health clinic visits, younger age, or being unmarried.

conclusionsThe drug screening initiative was relatively successful in its first-year implementation, having screened 70% of eligible subjects. However, it failed to screen many of those most likely to screen positive, thereby missing many opportunities to address unhealthy drug use. Future refinements should include better training clinicians in how to ask sensitive questions and how to address positive screens.

Indexed as

United States Department of Veterans AffairsAdolescentAdultAgedAged, 80 and overAge FactorsFemaleHumansMaleMassachusettsMass ScreeningMiddle AgedOutpatientsProgram EvaluationRetrospective StudiesRisk FactorsAlcoholdrug usescreeningveterans

Identifiers

PMID29595402
PMCPMC6163096
OpenAlexW2794591683

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.