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    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.

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    Date
    2016-01
    Authors
    Batch, Bryan Courtney
    Brady, KT
    Dunham, AA
    Ghitza, UE
    Heidenfelder, B
    Killeen, TK
    Lindblad, R
    Rusincovitch, SA
    Spratt, SE
    VanVeldhuisen, P
    Wu, LT
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    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 article
    Subject
    Diabetes
    Home-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/10161/10996
    Published Version (Please cite this version)
    10.1016/j.cct.2015.11.009
    Publication 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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    Scholars@Duke

    Batch

    Bryan Courtney Batch

    Associate Professor of Medicine
    Type 2 Diabetes, Obesity/Overweight, Behavior change, Non-pharmacologic intervention, Health disparities
    Open Access

    Articles written by Duke faculty are made available through the campus open access policy. For more information see: Duke Open Access Policy

    Rights for Collection: Scholarly Articles

     

     

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