Sharon Levy1, Aria Wiseblatt, John H Straus, Heather Strother, Christina Fluet, Sion K Harris. 1. Adolescent Substance Use and Addiction Program, Division of Developmental Medicine, Boston Children's Hospital, Boston, MA (SL, AW); Department of Pediatrics, Harvard Medical School, Boston, MA (SL, SKH); Center for Adolescent Substance Abuse Research, Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA (SKH); Division of Child, Youth, and Family Services, Massachusetts Department of Mental Health, Boston, MA (HS, CF); Massachusetts Child Psychiatry Access Program, Massachusetts Behavioral Health Partnership, Beacon Health Options, Boston, MA (JHS).
Abstract
OBJECTIVES: Adolescent Screening, Brief Intervention, and Referral to Treatment (SBIRT) in primary care is a key strategy to prevent, identify, and respond to substance use problems and disorders, including opioid and other drug addictions. Despite substantial investment in recent years to increase its implementation, few studies have reported on recent levels of SBIRT implementation among pediatricians. We aimed to assess self-reported use of the SBIRT framework with adolescent patients among Massachusetts pediatricians, and describe trends since an earlier survey. METHODS: We analyzed responses to a cross-sectional survey mailed in 2017 to a representative sample of pediatricians in Massachusetts. We computed response frequencies for all SBIRT practice questions. We used the chi-square test to compare current data to data collected in 2014, as we found no demographic differences between the 2 samples. RESULTS: Nearly all pediatricians in the 2017 sample (n = 160) reported annual screening of their adolescent patients (99%). The majority reported giving positive reinforcement (87%), brief advice (92%), counseling (90%), and referral to treatment (66%) in response to screen results. Compared with 2014, a significantly higher proportion of pediatricians in 2017 referred patients who screened positively for problematic alcohol use, but perceived barriers to screening and follow-up remain, such as insufficient time to screen and patient refusal to return. CONCLUSIONS: Among respondents to a Massachusetts pediatrician survey, we found high rates of delivering SBIRT in accordance with published guidelines, though barriers remain. Whether the content of the counseling adheres to guidelines is unknown.
OBJECTIVES: Adolescent Screening, Brief Intervention, and Referral to Treatment (SBIRT) in primary care is a key strategy to prevent, identify, and respond to substance use problems and disorders, including opioid and other drug addictions. Despite substantial investment in recent years to increase its implementation, few studies have reported on recent levels of SBIRT implementation among pediatricians. We aimed to assess self-reported use of the SBIRT framework with adolescent patients among Massachusetts pediatricians, and describe trends since an earlier survey. METHODS: We analyzed responses to a cross-sectional survey mailed in 2017 to a representative sample of pediatricians in Massachusetts. We computed response frequencies for all SBIRT practice questions. We used the chi-square test to compare current data to data collected in 2014, as we found no demographic differences between the 2 samples. RESULTS: Nearly all pediatricians in the 2017 sample (n = 160) reported annual screening of their adolescent patients (99%). The majority reported giving positive reinforcement (87%), brief advice (92%), counseling (90%), and referral to treatment (66%) in response to screen results. Compared with 2014, a significantly higher proportion of pediatricians in 2017 referred patients who screened positively for problematic alcohol use, but perceived barriers to screening and follow-up remain, such as insufficient time to screen and patient refusal to return. CONCLUSIONS: Among respondents to a Massachusetts pediatrician survey, we found high rates of delivering SBIRT in accordance with published guidelines, though barriers remain. Whether the content of the counseling adheres to guidelines is unknown.
Authors: Francis Vergunst; Nicholas Chadi; Massimiliano Orri; Camille Brousseau-Paradis; Natalie Castellanos-Ryan; Jean R Séguin; Frank Vitaro; Daniel Nagin; Richard E Tremblay; Sylvana M Côté Journal: Eur Child Adolesc Psychiatry Date: 2021-05-31 Impact factor: 4.785