Clinicians' Beliefs and Practices Regarding Drug Use Care of Their Community Health Center Patients.
Clinicians' Beliefs and Practices Regarding Drug Use Care of Their Community Health Center Patients.
复制标题
临床医生关于社区健康中心患者药物使用护理的信念和实践。
DOI：
10.1097/adm.0000000000000158
复制
发表时间：
2015
影响因子：
5.5
通讯作者：
Gelberg,Lillian
中科院分区：
文献类型：
--
作者：
Reddy,AnjaniT;Andersen,RonaldM;Gelberg,Lillian
Objectives:Integration of behavioral health including substance use problems into primary care is an essential benefit that federally qualified health centers (FQHCs) will offer as part of the Affordable Care Act. This study explores FQHC primary care clinicians’ beliefs and practices regarding illicit drug use assessment and treatment.Methods:We administered a 10-minute questionnaire to 68 primary care clinicians of 5 FQHCs in Los Angeles.Results:Clinicians expressed limited confidence in their ability to address patients’ illicit drug use, scoring on average 3.31 on a 5-point Likert scale. Two thirds reported that they assess for drug use routinely “at every visit” and/or “at annual visits.” When asked how often they counsel regarding drug use (on a 5-point Likert scale from “never” to “always”), the median response was 4 (“usually”). Regarding their perspectives on the best practical resource for addressing drug use in their clinics, 45.6% named primary care clinicians. A minority (29.4%) of clinicians had completed a clinical rotation dealing with substance use, and 27.2% reported receiving more than 10 hours of training regarding substance use problems. Having a substance use rotation was associated with greater confidence in drug use assessment and treatment (P< 0.01). More hours of substance use training was associated with greater confidence (P= 0.01) and routinely addressing substance use in their patients (P= 0.04).Conclusions:Although two thirds of the surveyed clinicians assess for drug use routinely, and on average, report that they usually address drug use, clinicians’ confidence in substance use care seems to be suboptimal, but both confidence and routinely addressing substance use are associated with increased substance use education. Improving clinicians’ training and integrating drug use care in FQHCs may improve confidence in substance use care and facilitate the Affordable Care Act's mandate to integrate behavioral health into routine FQHC primary care.
