The remote brief intervention and referral to treatment model: Development, functionality, acceptability, and feasibility
Department of Emergency Medicine
Health Information Technology | Psychiatry and Psychology | Substance Abuse and Addiction
BACKGROUND: Screening, brief intervention, and referral to treatment (SBIRT) is effective for reducing risky alcohol use across a variety of medical settings. However, most programs have been unsustainable because of cost and time demands. Telehealth may alleviate on-site clinician burden. This exploratory study examines the feasibility of a new Remote Brief Intervention and Referral to Treatment (R-BIRT) model.
METHODS: Eligible emergency department (ED) patients were enrolled into one of five models. (1) Warm Handoff: clinician-facilitated phone call during ED visit. (2) Patient Direct: patient-initiated call during visit. (3) Electronic Referral: patient contacted by R-BIRT personnel post visit. (4) Patient Choice: choice of models 1-3. (5) Modified Patient Choice: choice of models 1-2, Electronic Referral offered if 1-2 were declined. Once connected, a health coach offered assessment, counseling, and referral to treatment. Follow up assessments were conducted at 1 and 3 months. Primary outcomes measured were acceptance, satisfaction, and completion rates.
RESULTS: Of 125 eligible patients, 50 were enrolled, for an acceptance rate of 40%. Feedback and satisfaction ratings were generally positive. Completion rates were 58% overall, with patients enrolled into a model wherein the consultation occurred during the ED visit, as opposed to after the visit, much more likely to complete a consultation, 90% vs. 10%, chi(2) (4, N=50)=34.8, p < 0.001.
CONCLUSIONS: The R-BIRT offers a feasible alternative to in-person alcohol SBIRT and should be studied further. The public health impact of having accessible, sustainable, evidence-based SBIRT for substance use across a range of medical settings could be considerable.
Brief motivational intervention, Referrals, Screening, Substance abuse, Technology, Telehealth
DOI of Published Version
Drug Alcohol Depend. 2015 Oct 1;155:236-42. doi: 10.1016/j.drugalcdep.2015.07.014. Epub 2015 Jul 23. Link to article on publisher's site
Drug and alcohol dependence
Boudreaux ED, Haskins B, Harralson T, Bernstein E. (2015). The remote brief intervention and referral to treatment model: Development, functionality, acceptability, and feasibility. University of Massachusetts Medical School Faculty Publications. https://doi.org/10.1016/j.drugalcdep.2015.07.014. Retrieved from https://escholarship.umassmed.edu/faculty_pubs/909