Using electronic health record data for substance use Screening, Brief Intervention, and Referral to Treatment among adults with type 2 diabetes: Design of a National Drug Abuse Treatment Clinical Trials Network study.
Abstract
BACKGROUND: The Affordable Care Act encourages healthcare systems to integrate behavioral
and medical healthcare, as well as to employ electronic health records (EHRs) for
health information exchange and quality improvement. Pragmatic research paradigms
that employ EHRs in research are needed to produce clinical evidence in real-world
medical settings for informing learning healthcare systems. Adults with comorbid diabetes
and substance use disorders (SUDs) tend to use costly inpatient treatments; however,
there is a lack of empirical data on implementing behavioral healthcare to reduce
health risk in adults with high-risk diabetes. Given the complexity of high-risk patients'
medical problems and the cost of conducting randomized trials, a feasibility project
is warranted to guide practical study designs. METHODS: We describe the study design,
which explores the feasibility of implementing substance use Screening, Brief Intervention,
and Referral to Treatment (SBIRT) among adults with high-risk type 2 diabetes mellitus
(T2DM) within a home-based primary care setting. Our study includes the development
of an integrated EHR datamart to identify eligible patients and collect diabetes healthcare
data, and the use of a geographic health information system to understand the social
context in patients' communities. Analysis will examine recruitment, proportion of
patients receiving brief intervention and/or referrals, substance use, SUD treatment
use, diabetes outcomes, and retention. DISCUSSION: By capitalizing on an existing
T2DM project that uses home-based primary care, our study results will provide timely
clinical information to inform the designs and implementation of future SBIRT studies
among adults with multiple medical conditions.
Type
Journal articleSubject
DiabetesHome-based primary care
Medical comorbidity
Referral to treatment
Substance use disorder
Substance use screening
Comorbidity
Diabetes Mellitus, Type 2
Electronic Health Records
Feasibility Studies
Humans
Mass Screening
North Carolina
Patient Protection and Affordable Care Act
Primary Health Care
Prospective Studies
Referral and Consultation
Substance-Related Disorders
Permalink
https://hdl.handle.net/10161/10996Published Version (Please cite this version)
10.1016/j.cct.2015.11.009Publication Info
Batch, Bryan Courtney; Brady, KT; Dunham, AA; Ghitza, UE; Heidenfelder, B; Killeen,
TK; ... Wu, LT (2016). Using electronic health record data for substance use Screening, Brief Intervention,
and Referral to Treatment among adults with type 2 diabetes: Design of a National
Drug Abuse Treatment Clinical Trials Network study. Contemp Clin Trials, 46. pp. 30-38. 10.1016/j.cct.2015.11.009. Retrieved from https://hdl.handle.net/10161/10996.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Bryan Courtney Batch
Associate Professor of Medicine
Type 2 Diabetes, Obesity/Overweight, Behavior change, Non-pharmacologic intervention,
Health disparities

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