December 2015

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Training Helps Doctors Spot, Treat At-Risk Teens

After brief training sessions, pediatricians were more likely to recognize and treat teens for problems like drug and alcohol use. The findings may help improve ways to address mental health and substance abuse issues.

Substance abuse during teen years is common and dangerous. Risks range from injuries and school troubles to long-lasting brain changes and addiction. Many teens who use drugs or alcohol also struggle with mental health issues.

Research has shown that adults can reduce heavy drinking and have other positive outcomes when their doctors use a technique called SBIRT, which stands for Screening, Brief Intervention, and Referral to Treatment.

NIH-funded scientists tested whether brief SBIRT training might also help pediatricians spot and treat problems in youth. The study, led by Dr. Stacy Sterling of Kaiser Permanente, involved nearly 50 pediatricians and 5,200 patients, ages 12 to 18, at a large pediatric clinic.

Doctors were divided into 3 groups. A “pediatrician-only” group received three 60-minute SBIRT training sessions. A second group had a 1-hour training session; they were asked to refer patients as needed to clinical psychologists “embedded” into the practices. A “usual-care” group of doctors didn’t receive SBIRT training or have psychologists embedded in their practices.

After SBIRT training, the pediatrician-only group was about 10 times more likely than the usual-care group to conduct brief interventions with at-risk patients (16% vs. 1.5%). The intervention rate was about 25% for SBIRT-trained pediatricians working with embedded psychologists.

“Embedding nonphysician clinicians in primary care could be a cost-effective alternative to pediatricians providing these services,” says senior author Dr. Constance Weisner of the University of California, San Francisco. Future analyses will look at patient outcomes and the cost-effectiveness of SBIRT approaches.