Psychosocial Interventions for Problem Alcohol Use in Primary Care Settings (PINTA): baseline feasibility data.

Objectives. Primary care is a key provider of long-term care for people who attend primary care for substance use treatment, especially those in methadone maintenance treatment. As many drink alcohol excessively, there is a need to address alcohol use to improve health outcomes. We examined problem alcohol use and its treatment among people who attend primary care for substance use treatment, using baseline data from a feasibility study of an evidence-based complex intervention to improve care. Methods. Data on addiction care processes were collected by (1) reviewing clinical records (n=129) of people who attended 15 General Practices (GP) for substance use treatment, (2) administering structured questionnaires to both patients (n=105), and General Practitioners (GPs) (n=15). Results. Clinical records indicated 24 (19%) were screened for problem alcohol use in the 12 months prior to data collection, with problem alcohol use identified in 14 (11%). Of those who screened positive for problem alcohol use, five received a ‘brief intervention’ by a GP, and none were referred to specialist treatment (SBIRT). Alcohol Use Disorders Identification Test (AUDIT) scores revealed the prevalence of hazardous, harmful and dependent drinking to be 23%, 5%, and 16% respectively; intraclass correlation coefficient (ICC) for the proportion of patients with negative AUDITs was 0.038 (Standard Error 0.01). The ICCs for SBIRT were 0.16 (SE= 0.014), -0.06 (0.017), and 0.22 (0.026) for screening, brief intervention and referral, respectively. Only 12 (11.5%) AUDIT questionnaires concurred with corresponding clinical records that a patient had any/ no problem alcohol use. Regular use of primary care was evident, as 25% had attended their GP more than 12 times during the past three months. Conclusions. Comparing clinical records with patients’ experience of SBIRT can shed light on the process of care. Alcohol screening of people who attend primary care for substance use treatment is not routinely conducted. Interventions that enhance the care of problem alcohol use among this high-risk group are a priority.