Beauchamp Julie R, Malmstrom Robert, Shayegani Ramona, Flynn Steve T, Robinson Amy E, Marin Jennifer R, Huberman David B, Taylor Janice M, Mambourg Scott E
VA Sierra Pacific Network (VISN 21).
Fed Pract. 2025 May;42(5):1-8. doi: 10.12788/fp.0562. Epub 2025 May 17.
Excessive alcohol use is a leading cause of preventable death in the United States. Despite the availability of effective alcohol use disorder (AUD) treatments, usage remain low. This quality improvement project explored the use of direct-to-consumer (DTC) patient education across multiple US Department of Veterans Affairs (VA) facilities to increase AUD treatment.
Patients with AUD or at high risk for AUD at 5 Veterans Integrated Service Network (VISN) 21 sites who were not receiving AUD pharmacotherapy were identified. Veterans were eligible for inclusion if they had an Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score ≥ 6 with an AUD diagnosis, or ≥ 8 without diagnosis, and a scheduled appointment with primary care, mental health, or a substance use disorder (SUD) health care practitioner between October 1, 2023, and January 31, 2024. The final cohort was mailed education materials about 2 weeks prior to their appointment. A comparator group from the previous year was identified using propensity score matching, and findings were assessed using logistic regression. The outcomes were assessed within 30 days of the scheduled visit, with the primary outcome being the initiation of pharmacotherapy and the secondary outcome being the placement of a consultation for mental health or SUD services.
DTC education was mailed to 1260 veterans. Primary and secondary outcomes did not find statistically significant differences between patients that received DTC education and the comparator group ( > .59).
Although the results of this study were not statistically significant, this project initiated conversations at the VISN around AUD and available treatments. Future research should focus on addressing primary care involvement in AUD treatment, assessing different methods for delivering DTC education, and its potential long-term impact in the treatment of AUD.
在美国，过度饮酒是可预防死亡的主要原因。尽管有有效的酒精使用障碍（AUD）治疗方法，但使用率仍然很低。这个质量改进项目探索了在美国退伍军人事务部（VA）多个设施中使用直接面向消费者（DTC）的患者教育来增加AUD治疗。
在退伍军人综合服务网络（VISN）21的5个地点，识别出患有AUD或有AUD高风险且未接受AUD药物治疗的患者。如果退伍军人的酒精使用障碍识别测试-消费版（AUDIT-C）得分≥6且已确诊为AUD，或得分≥8且未确诊，并且在2023年10月1日至2024年1月31日期间安排了与初级保健、心理健康或物质使用障碍（SUD）医疗保健从业者的预约，则有资格纳入。最终队列在预约前约2周收到教育材料。使用倾向得分匹配法确定上一年的对照组，并使用逻辑回归评估结果。在预定就诊的30天内评估结果，主要结果是开始药物治疗，次要结果是安排心理健康或SUD服务咨询。
向1260名退伍军人邮寄了DTC教育材料。接受DTC教育的患者与对照组之间的主要和次要结果在统计学上没有显著差异（P>.59）。
尽管本研究结果在统计学上不显著，但该项目在VISN引发了关于AUD和可用治疗方法的讨论。未来的研究应侧重于解决初级保健在AUD治疗中的参与问题，评估提供DTC教育的不同方法及其在AUD治疗中的潜在长期影响。
