Screening, Brief Intervention & Referral (SBIR)

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Presentation transcript:

Screening, Brief Intervention & Referral (SBIR) 4/29/2018 CSAM-SCAM Fundamentals Screening, Brief Intervention & Referral (SBIR) Dr. David Luckow, CFPC, DABAM, MRO Adapted from presentation by Peter R. Butt, MD CCFP (EM), FCFP

Disclosures No financial or pharma conflict of interest.

30-second summary S – Screening BI – Brief Intervention R - Referral

Objectives WWW.SBIR-DIBA.CA Review the origin of Canada’s SBIR initiative. Explore the process of SBIR for various risk categories. Explore the CFPC website: WWW.SBIR-DIBA.CA

Development and Background Alcohol SBIR CCSA and CFPC Development and Background

Canada’s National Alcohol Strategy Led by the Canadian Centre on Substance Abuse. Developed a comprehensive, collaborative, stakeholder endorsed set of 41 recommendations: Reducing Alcohol Related Harm in Canada: Toward a Culture of Moderation (CCSA 2007)

Alcohol SBIR: NAS Recommendations #7 Develop integrated, culturally sensitive screening, brief intervention and referral (SBIR) tools and strategies #9 Improve access to addiction services in isolated, rural and remote regions of Canada, and for vulnerable populations.

Development and Implementation Online prototype was developed and tested by the CFPC CFPC now maintains the site, with open access

Challenges to Primary Care SBIR Uptake Need for national Low Risk Drinking Guidelines Credible information and endorsement Time: seamless inclusion in busy practices

Challenges to Primary Care SBIR Uptake Comfort with the process and inclusion of Motivational Interviewing Ability to address alcohol use disorder Appropriate technology and resources for both the practice and patient.

The Site The Site College of Family Physicians of Canada, open source www.sbir-diba.ca

low-risk drinking guidelines Alcohol SBIR The site, low-risk drinking guidelines and Standard Drinks

Alcohol SBIR Menu Orientation

Break to web browser

Screening and Assessment Alcohol SBIR Screening and Assessment

Screening Alternatives Evidence based LRDG’s Waiting room screening alternatives: 1) Primary level AUDIT-C, CRAFFT, or PHQ 4 2) Secondary level GAINS-SS Potential for App and EMR migration of broader lifestyle and mental health screening, with focused intervention.

Brief Intervention and Referral Alcohol SBIR Brief Intervention and Referral

Stages of Change Relapse Pre-contemplation Success Maintenance Planning Action Maintenance Relapse Success (Prochaska & Di Clemente, Transtheoretical Model of Change)

A Motivational Approach Start wherever the person is at: acknowledge their reality Roll with resistance Avoid arguments or a power struggle Be persuasive, not confrontational or abusive

Brief Intervention, Follow up and Support for Elevated Risk Alcohol SBIR Brief Intervention, Follow up and Support for Elevated Risk

Brief Intervention, Follow up and Support for Alcohol Abuse Alcohol SBIR Brief Intervention, Follow up and Support for Alcohol Abuse

Alcohol SBIR Brief Intervention, Referral, Follow up and Support for Alcohol Dependency

Objectives Accomplished Review the origin of Canada’s SBIR initiative Explore the content and format Explore the CFPC website: WWW.SBIR-DIBA.CA

References & Recommended Reading American Society of Addiction Medicine, www.ASAM.org Canadian Society of Addiction Medicine, www.CSAM-SMCA.org Canadian Centre on Substance Abuse, www.CCSA.ca National Institute of Drug Abuse, www.NIDA.org National Native Addiction Partnership Foundation, www.nnapf.org Wellbriety Movement, www.whitebison.org Mate, Gabor. In The Realm of Hungry Ghosts. A.A.Knopf Canada. 2008