Candidate performance measures for screening for, assessing, and treating unhealthy substance use in hospitals: advocacy or evidence-based practice?

Annals of Internal Medicine
Richard Saitz

Abstract

The Joint Commission recently proposed candidate performance measures addressing unhealthy substance use in hospitalized patients. The proposed measures of screening and brief intervention (SBI) assume that interventions that work in one setting (primary care outpatient practice) would work in another (hospital); treatment would have the same benefits for persons identified by screening as for those with symptoms who seek help; treatments that work for persons less severely affected by substance use would also work for those with more severe illness; and an approach that works for nondependent, unhealthy alcohol use would work for drug use. However, these assumptions extrapolate evidence of the effectiveness of SBI for primary care outpatients with nondependent, unhealthy alcohol use to the inpatient setting, persons with dependence, and other substances. Although quality of care for unhealthy substance use in all medical settings needs to improve, the evidence base for SBI in the hospital is too limited for the implementation of performance measures assessing this care.

Citations

Jul 12, 2011·Current Psychiatry Reports·Graeme B WilsonEileen F S Kaner
Mar 25, 2011·Current Opinion in Psychiatry·Antoni Gual, Michaela B do Amaral Sabadini
Jun 7, 2013·Addiction Science & Clinical Practice·Regina Makdissi, Scott H Stewart
Aug 21, 2013·Journal of General Internal Medicine·Anna PecoraroGeorge Woody
Oct 26, 2013·The American Journal of Medicine·Richard Saitz
May 12, 2015·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Nnenna KaluRobert E Taylor
Jan 6, 2016·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Brendan J ClarkKatharine A Bradley
Jan 19, 2012·Alcoholism, Clinical and Experimental Research·Lauren M BroylesAdam J Gordon
Jun 5, 2020·The Journal of Behavioral Health Services & Research·Chad D Morris, Christine E Garver-Apgar

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