A suite of web apps for patients with alcohol & drug use problems in primary care

描述（由申请人提供）：在美国，每年大量饮酒的医疗保健费用估计为246亿美元（Bouchery等人，2011年）。有效地干预危险，危险和问题饮酒者将降低他们的发病率和医疗费用。解决问题饮酒者需求的一种方法是在初级保健中对他们进行筛查和干预。然而，初级保健提供者提供这些服务是不可行的。 服务相反，医疗保健正朝着这些服务整合到初级保健使用行为健康顾问。这种整合现在已经开始在新墨西哥州和全国范围内发生（Clay，2012）。大多数心理健康顾问虽然没有解决酒精和毒品问题的专业知识。该项目旨在帮助解决这个问题，为他们提供一个经验支持的计划，可以是他们的努力的辅助。该项目的总体目标是开发、评估和传播一个名为“检查和选择”（CC）的网络应用程序。CC将被开发用于初级保健。它将紧密结合大量饮酒和药物使用的筛查，对危险或大量饮酒者的简短动机干预，对依赖性较低的问题饮酒者的适度训练方案，以及对更多依赖性饮酒者和药物滥用者的禁欲方案。简短的动机干预将根据患者的年龄进行调整。它的目的将是激励问题饮酒者改变他们的饮酒习惯。以行动为导向的适度和禁欲协议是认知行为干预（CBIs），为患者提供技能，以最大限度地提高他们改变饮酒和/或药物使用的成功机会。我们已经开发了这些元素，但它们没有集成到一个单独的程序中，并在它们之间进行适当的分支。内容也没有针对初级保健的使用。这种行为健康服务的整合被认为是一种双赢的方式，可以改善患者的健康状况，同时降低医疗成本。整合服务的举措也被认为是必要的，以便为2014年1月实施国家医疗保健改革带来的服务需求增加做好准备。 公共卫生相关性：在地方和国家一级，医疗保健组织正在努力将心理健康和药物滥用服务纳入初级保健。该网络应用程序可以满足希望使用干预的阶梯式护理模式提供药物滥用服务的组织的一些需求。

DESCRIPTION (provided by applicant): The annual healthcare costs of heavy drinking in the U.S. are estimated to be $24.6 billion (Bouchery et al., 2011). Effectively intervening with hazardous, risky, and problem drinkers would reduce both their morbidity and their healthcare costs. One way to address the needs of problem drinkers is by screening for and intervening with them in primary care. It is not feasible, however, for primary care providers to provide these services. Instead, healthcare is moving towards the integration of these services into primary care using behavioral health counselors. This integration is starting to happen now both in New Mexico and nationally (Clay, 2012). Most mental health counselors though do not have expertise is addressing alcohol and drug issues. This project seeks to help address this problem by providing them with an empirically supported program that could be an adjunct to their efforts. The overall objective of this project is to develop, evaluate, and disseminate a web application called Check-up and Choices (CC). CC will be developed for use in primary care. It would tightly integrate screening for heavy drinking and drug use, a brief motivational intervention for hazardous or heavy drinkers, a moderation training protocol for less dependent problem drinkers, and an abstinence-oriented protocol for more dependent drinkers and drug abusers. The brief motivational intervention will be tailored to the patient's age. Its purpose wil be to motivate problem drinkers to change their drinking. The action-oriented moderation and abstinence protocols are cognitive-behavioral interventions (CBIs) that provide patients with the skills to maximize their chances of success with changing their drinking and/or drug use. We have already developed these elements but they are not integrated into a single program with appropriate branching between them. Nor has the content been tailored for use in primary care. This integration of behavioral health services is seen as a win-win that improves the health of patients while at the same time reduces healthcare costs. The move to integrate services is also seen as necessary to be ready for the increased demand for services that will accompany the implementation of national healthcare reform in January, 2014. PUBLIC HEALTH RELEVANCE: At both the local and national level, healthcare organizations are moving towards integrating mental health and substance abuse services into primary care. This web application could meet some of the needs of organizations wishing to provide substance abuse services using a stepped care model of intervention.