The remote brief intervention and referral to treatment model: Development, functionality, acceptability, and feasibility

Abstract

Background Screening, brief intervention, and referral to treatment (SBIRT) is effective for reducing risky alcohol use across a variety of medical settings. However, most programs have been unsustainable because of cost and time demands. Telehealth may alleviate on-site clinician burden. This exploratory study examines the feasibility of a new Remote Brief Intervention and Referral to Treatment (R-BIRT) model. Methods Eligible emergency department (ED) patients were enrolled into one of five models. (1) Warm Handoff: clinician-facilitated phone call during ED visit. (2) Patient Direct: patient-initiated call during visit. (3) Electronic Referral: patient contacted by R-BIRT personnel post visit. (4) Patient Choice: choice of models 1–3. (5) Modified Patient Choice: choice of models 1–2, Electronic Referral offered if 1–2 were declined. Once connected, a health coach offered assessment, counseling, and referral to treatment. Follow up assessments were conducted at 1 and 3 months. Primary outcomes measured were acceptance, satisfaction, and completion rates. Results Of 125 eligible patients, 50 were enrolled, for an acceptance rate of 40%. Feedback and satisfaction ratings were generally positive. Completion rates were 58% overall, with patients enrolled into a model wherein the consultation occurred during the ED visit, as opposed to after the visit, much more likely to complete a consultation, 90% vs. 10%, χ2 (4, N=50) = 34.8, p<0.001. Conclusions The R-BIRT offers a feasible alternative to in-person alcohol SBIRT and should be studied further. The public health impact of having accessible, sustainable, evidence-based SBIRT for substance use across a range of medical settings could be considerable.

Exploring Factors Associated with Alcohol and/or Substance Use During the COVID-19 Pandemic

“…An area of focus for practice will be to train clinicians in the use of SBIRT online while identifying additional avenues for universal implementation, perhaps through the use of social media. Boudreaux et al ( 2015 ) demonstrated the potential in such practice. In addition, as has been suggested by Goodwin et al ( 2018 ) previously, public health officials and clinicians might consider creating anxiety-mediating interventions that target social media users during times of crises, such as the COVID-19 pandemic, in an effort to curtail the spread of emotional contagion and/or to promote healthy coping among social media users.…”

Substance use screening and brief intervention: Evaluation of patient and implementation differences between primary care and emergency department settings

“…Different communication and service delivery strategies should be investigated in team‐based SBIRT models in order to find the most successful workflows. In addition, there may be opportunities to reach out to patients after their visits to conduct SBIRT using technology or phone‐based models, rather than conducting SBIRT during the patient visit . Future research should examine whether clinical setting and workflow adaptations increase implementation success.…”

Investigating the Need for Point-of-Care Robots to Support Teleconsultation

“…The initial online questionnaire was developed by researchers in health care and nursing informatics ( Table 1). 2,[7][8][9][10][11][12][13][14] It included 2 questions about which departments would use the robots and 38 on essential features of the teleconsultation robot.…”