1. PRACTITIONERS, AND PHYSICIAN ASSISTANTS
KNOWLEGE, TRAINING, AND SBIRT PRACTICE AMONG NEW YORK STATE PHYSICIANS, NURSE
PRACTITIONERS, AND PHYSICIAN ASSISTANTS
J. Yu1, PhD; B.R. Harris2, DrPH; S. DeStafeno2, MA; M. O’Grady3, PhD
Background
Results
Screening Tools Used
Most did not report using a tool that reliably identifies risky substance use (Chart 3):
78% reported asking patients directly about their use without using a screening tool
66% reported using the CAGE which identifies substance dependence, not risky use.
Past research has indicated the cost-effectiveness of Screening, Brief Intervention, and Referral to Treatment (SBIRT) as an early intervention strategy in various healthcare and public health settings, including the primary care settings, to address risky use and substance use disorders.
The Office of National Drug Control Policy has included SBIRT in its current drug control strategy
New York State is promoting the statewide expansion and sustainability of SBIRT.
This study examines the extent to which SBIRT is currently being integrated in primary care in New York State.
Survey Responses
The survey received 258 responses (Chart 1)
Training of SBIRT
Less than half of respondents had received
training in how to (Chart 2):
screen patients for substance use
advise patients about risky substance use
provide referrals to specialty treatment
Gap in Knowledge
Only 28% reported being somewhat or very familiar with the SBIRT model
Most respondents did not use a screening tool required for Medicaid reimbursement
Fifty-nine percent of respondents reported rarely or never billing for SBIRT.
Conclusions
Findings suggest need for increasing awareness of:
The SBIRT model
Federal and state recommendations for conducting SBIRT
Requirements for billing and reimbursement by insurance plans for screening and intervention
Results also have implications for other states that are making efforts to integrate SBIRT in primary care.
Further research is required to study factors associated with levels of practice identified in this survey.
Methods
Between October and November 2013, an electronic survey was ed to members of:
The Medical Society of the State of New York (MSSNY)
The Nurse Practitioner Association of New York (NPANY)
New York State Society of Physician Assistants (NYSSPA)
The survey focused on SBIRT knowledge, training, and practice among primary care professionals to obtain a better understanding of the future needs in the development of a statewide strategic plan for integration of SBIRT in the primary care setting.
Practice of SBIRT
56% reported screening for substance use
45% reported conducting brief interventions,
47% reported providing referrals to specialty treatment
Author Affiliations
School of Social Welfare, University at Albany, State University of New York
New York State Office of Alcoholism and Substance Abuse Services
National Center on Addiction and Substance Abuse at Columbia University