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Interactive Voice Response Technology Can Deliver Alcohol Screening and Brief Intervention in Primary Care

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Abstract

BACKGROUND

Alcohol screening and brief intervention (BI) is an effective primary care preventive service, but implementation rates are low. Automating BI using interactive voice response (IVR) may be an efficient way to expand patient access to needed information and advice.

OBJECTIVE

To develop IVR-based BI and pilot test it for feasibility and acceptability.

DESIGN

Single-group pre-post feasibility study.

PARTICIPANTS

Primary care patients presenting for an office visit.

INTERVENTIONS

IVR-BI structured to correspond to the provider BI method recommended by NIAAA: (1) Ask about use; (2) Assess problems; (3) Advise and Assist for change, and (4) Follow up for continued support. Advice was tailored to patient readiness and preferences.

MEASUREMENTS

Utilization rate, call duration, and patients’ subjective reports of usefulness, comfort and honesty with the IVR-BI. Pre-post evaluation of motivation to change and change in alcohol consumption as measured by Timeline Follow Back.

RESULTS

Call duration ranged from 3–7 minutes. Subjective reactions were generally positive or neutral. About 40% of subjects indicated IVR-BI had motivated them to change. About half of the patients had discussed drinking with their provider at the visit. These tended to be heavier drinkers with greater concerns about drinking. Patients who reported a provider-delivered BI and called the IVR-BI endorsed greater comfort and honesty with the IVR-BI. On average, a 25% reduction in alcohol use was reported two weeks after the clinic visit.

CONCLUSIONS

Using IVR technology to deliver BI in a primary care setting is feasible and data suggest potential for efficacy in a larger trial.

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Acknowledgements

We gratefully acknowledge the assistance of Megan Malgeri in gathering the IVR-screen pre-test data.

We also would like to thank Dee Scheidel and all the staff at Given Essex for collaborating on this study.

This research was supported by NIAAA grant 1 R21 AA015777-01A1.

An abstract of this study was presented at a poster session at the Society of General Internal Medicine annual meeting, Miami, FL, May, 2009. This research was also presented as part of a symposium at the Research Society on Alcoholism annual meeting, San Diego, CA, June, 2009.

Conflict of Interest

None disclosed.

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Authors and Affiliations

  1. The University of Vermont, Burlington, VT, USA

    Gail L. Rose PhD, Charles D. MacLean MD, Joan Skelly MS, Gary J. Badger MS, Tonya A. Ferraro BA & John E. Helzer MD

Authors
  1. Gail L. Rose PhD
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  2. Charles D. MacLean MD
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  3. Joan Skelly MS
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  4. Gary J. Badger MS
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  5. Tonya A. Ferraro BA
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  6. John E. Helzer MD
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Corresponding author

Correspondence to Gail L. Rose PhD.

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Rose, G.L., MacLean, C.D., Skelly, J. et al. Interactive Voice Response Technology Can Deliver Alcohol Screening and Brief Intervention in Primary Care. J GEN INTERN MED 25, 340–344 (2010). https://doi.org/10.1007/s11606-009-1233-0

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  • DOI: https://doi.org/10.1007/s11606-009-1233-0

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