The article, “Why Substance Use Screening Frequency Matters in Adult Primary Care,” has been published in SAj.
The authors state that evidence-based early intervention practices, such as screening, brief intervention, and referral to treatment (SBIRT), are recommended to identify unhealthy use and provide linkages to treatment to prevent substance use disorder. However, there is a lack of screening frequency recommendations. Pennsylvania (PA) SBIRT was a five-year initiative to implement SBIRT in primary care sites. This study evaluated the effects of screening policies in PA SBIRT on changes in substance use risk category over time.
In the AUTHORS’ OWN WORDS, they relate the importance of their work:
“The USPSTF lacks explicit guidance regarding screening frequency, stating that there is little or inadequate evidence around the optimal screening interval. Studies reviewing screening implementation to evaluation are plentiful, but also lack guidance around screening frequency. In lieu of strong evidence to guide policies, healthcare sites may generate policies based on how heavily they weigh convenience versus perceived risk about how quickly substance use can escalate to hazardous levels. Providers who weighed convenience tended to prefer annual screenings bundled with general health screening visits; providers who were concerned about how quickly substance use can escalate were more likely to advocate for more frequent screenings, as annual screenings alone could miss opportunities for early intervention. Additionally, universal screening integrated within the workflow may reduce biases in screening and identification of individuals using substances. Given the inquiries from the healthcare sites, lack of explicit guidance from the USPSTF, and PERU’s positionality with the robust data set, PERU conducted a secondary analysis from the PA SBIRT screening data to examine patterns and direction of change in substance use risk category among patients being screened on multiple occasions. The results generated initial insights into the applicability of frequent screening policies.”
“Screening in adult primary care settings is recommended to reduce substance use. The results from this analysis function as a catalyst to further evaluate recommended screening intervals for detecting unhealthy substance use to increase identification and patient connection to care. This analysis points to potential benefits of frequent screening policies. Evidence-based screening tools, along with policies that implement frequent screening, may further support providers to identify patients at risk of SUD and connect them to appropriate care. Healthcare professionals should consider these findings supporting frequent, universal screening when determining policies on screening frequency for substance use identification.”