2.50
Hdl Handle:
http://hdl.handle.net/10755/158098
Type:
Presentation
Title:
Improving the Quality of Patient Care With Substance Abuse Problems
Abstract:
Improving the Quality of Patient Care With Substance Abuse Problems
Conference Sponsor:Western Institute of Nursing
Conference Year:2004
Author:Lopez-Bushnell, Kathy, RNC, EdD, MPH, MSN
P.I. Institution Name:The University of New Mexico Hospital
Contact Address:931 Camino Ranchitos NW, Albuquerque, NM, 87114, USA
A statement of the need or problem: Alcohol abuse is a primary cause of preventable illness, disability, and mortality in the United States (National Institute on Alcohol Abuse and Alcoholism. 2001, White, Luckie, & Miller 1996, McGinnis, Foege 1999). New Mexico has the nation’s highest per capita rates of alcohol- and drug-related mortality, as well as the highest percentage of citizens with no medical insurance coverage and thus without ready access to health care (Geronimus, Korenman 1993). Like other public hospitals, the University of New Mexico Hospital provides health care to uninsured and indigent patients, many of whom are hospitalized for medical conditions related to alcohol abuse and dependence. Patients who screen positive for a substance use disorder (25% of inpatient medical admissions at our facility) have longer lengths of stay, more frequent discharges against medical advice, and more frequent re-admissions relative to other patients. Despite the associated disproportionately high health care utilization and costs, alcohol problems remain largely unaddressed among patients hospitalized for medical reasons. At most, referral is made to specialist alcoholism treatment facilities, and a majority of such referrals are never completed. Within a randomized clinical trial, we propose to test the efficacy of motivational interviewing (MI) alone and in combination with community case management (CCM) as transferrable and relatively low-cost interventions for alcohol use disorders among patients admitted for medical care. Theoretical framework: The theoretical framework is the Transtheoretical Model as expressed in the stage of change developed by Prochaska and DiClemente. Description of the sample: The sample consists of 300 hospitalized patients with substance abuse problems who are randomized into one of three groups after signing the consent form. Methods: Patients who score higher than 7 on the AUDIT and meet eligibility criteria, are asked to sign consent forms and then they complete the demographic interview followed by assessment for alcohol dependence and then randomized into one of three groups: 1) will receive Motivational Interviewing, 2) will receive Case Management and 3) will be the control group. Research findings/results: The findings include the efficacy of motivational interviewing and case management during medical hospitalization as a brief intervention for alcohol use disorders including (1) alcohol use, (2) alcohol-related problems and quality of life, and (3) health care utilization and costs. Conclusions: The conclusions focus on the effect of these evidence based interventions on the change of behavior of these patients and thus on the cost and effectiveness of motivational interviewing and case management.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImproving the Quality of Patient Care With Substance Abuse Problemsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/158098-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Improving the Quality of Patient Care With Substance Abuse Problems </td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Lopez-Bushnell, Kathy, RNC, EdD, MPH, MSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The University of New Mexico Hospital</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">931 Camino Ranchitos NW, Albuquerque, NM, 87114, USA</td></tr><tr><td colspan="2" class="item-abstract">A statement of the need or problem: Alcohol abuse is a primary cause of preventable illness, disability, and mortality in the United States (National Institute on Alcohol Abuse and Alcoholism. 2001, White, Luckie, &amp; Miller 1996, McGinnis, Foege 1999). New Mexico has the nation&rsquo;s highest per capita rates of alcohol- and drug-related mortality, as well as the highest percentage of citizens with no medical insurance coverage and thus without ready access to health care (Geronimus, Korenman 1993). Like other public hospitals, the University of New Mexico Hospital provides health care to uninsured and indigent patients, many of whom are hospitalized for medical conditions related to alcohol abuse and dependence. Patients who screen positive for a substance use disorder (25% of inpatient medical admissions at our facility) have longer lengths of stay, more frequent discharges against medical advice, and more frequent re-admissions relative to other patients. Despite the associated disproportionately high health care utilization and costs, alcohol problems remain largely unaddressed among patients hospitalized for medical reasons. At most, referral is made to specialist alcoholism treatment facilities, and a majority of such referrals are never completed. Within a randomized clinical trial, we propose to test the efficacy of motivational interviewing (MI) alone and in combination with community case management (CCM) as transferrable and relatively low-cost interventions for alcohol use disorders among patients admitted for medical care. Theoretical framework: The theoretical framework is the Transtheoretical Model as expressed in the stage of change developed by Prochaska and DiClemente. Description of the sample: The sample consists of 300 hospitalized patients with substance abuse problems who are randomized into one of three groups after signing the consent form. Methods: Patients who score higher than 7 on the AUDIT and meet eligibility criteria, are asked to sign consent forms and then they complete the demographic interview followed by assessment for alcohol dependence and then randomized into one of three groups: 1) will receive Motivational Interviewing, 2) will receive Case Management and 3) will be the control group. Research findings/results: The findings include the efficacy of motivational interviewing and case management during medical hospitalization as a brief intervention for alcohol use disorders including (1) alcohol use, (2) alcohol-related problems and quality of life, and (3) health care utilization and costs. Conclusions: The conclusions focus on the effect of these evidence based interventions on the change of behavior of these patients and thus on the cost and effectiveness of motivational interviewing and case management. </td></tr></table>en_GB
dc.date.available2011-10-26T20:30:25Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:30:25Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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