Screening and brief intervention for unhealthy substance use in patients with chronic medical conditions: a systematic review.
Christine Timko, Calvin Kong, Lisa Vittorio and 1 others
PMID 27140392WHAT IT FOUND
AUDIT and AUDIT-C may detect unhealthy alcohol use in primary care patients with hypertension, diabetes, or depression, and brief advice may reduce drinking in some groups.
Evidence is limited and does not cover illicit drug screening.
Key findings
01Brief alcohol intervention reduced heavy drinking and improved biomarker results in patients with hypertension or diabetes.
02Higher AUDIT-C scores were associated with poorer medication adherence in hypertensive patients, but not in patients taking oral hypoglycaemic agents.
03The review found no included studies of illicit drug screening in primary care patients with the selected chronic conditions, and the evidence base was small.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only hypertension, diabetes, and depression were reviewed, so it does not address other chronic conditions. The search was limited to primary care and English-language articles, so other settings and languages were not included. The review did not examine referral to treatment, so it says nothing about what happens after a positive screen. No included study screened for illicit drug use in these chronic disease patients. Brief intervention results were inconsistent across subgroups, including patients with comorbid depression. The evidence base was small, and many findings came from patients already in routine primary care.
The easy way to misread this
Do not conclude that this review supports screening or brief intervention for illicit drug use in chronic disease patients. It found no included studies of illicit drug screening in these patients.