Effect of a Care Management Intervention on 12-Month Drinking Outcomes Among Patients With and Without DSM-IV Alcohol Dependence at Baseline.

Background: The CHOICE care management intervention did not improve drinking relative to usual care (UC) for patients with frequent heavy drinking at high risk of alcohol use disorders. Patients with alcohol dependence were hypothesized to benefit most. We conducted preplanned secondary analyses to test whether the CHOICE intervention improved drinking relative to UC among patients with and without baseline DSM-IV alcohol dependence.

Alcohol-Related Nurse Care Management in Primary Care: A Randomized Clinical Trial.

Importance: Experts recommend that alcohol use disorders (AUDs) be managed in primary care, but effective approaches are unclear.

Objective: To test whether 12 months of alcohol care management, compared with usual care, improved drinking outcomes among patients with or at high risk for AUDs.

Design, Setting, And Participants: This randomized clinical trial was conducted at 3 Veterans Affairs (VA) primary care clinics.

Patient-centered primary care for adults at high risk for AUDs: the Choosing Healthier Drinking Options In primary CarE (CHOICE) trial.

Background: Most patients with alcohol use disorders (AUDs) never receive alcohol treatment, and experts have recommended management of AUDs in primary care. The Choosing Healthier Drinking Options In primary CarE (CHOICE) trial was a randomized controlled effectiveness trial of a novel intervention for primary care patients at high risk for AUDs. This report describes the conceptual and scientific foundation of the CHOICE model of care, critical elements of the CHOICE trial design consistent with the Template for Intervention Description and Replication (TIDieR), results of recruitment, and baseline characteristics of the enrolled sample.

Preliminary outcomes from an integrated mental health primary care team.

The effects of establishing a multidisciplinary mental health primary care team in a Veterans Affairs internal medicine primary care clinic were evaluated. The multidisciplinary team worked in collaboration with primary care providers to evaluate and treat their patients, who had a wide variety of psychiatric disorders, in the primary care clinic. In the first year of operation preliminary outcomes indicated that the rate of referrals to specialty mental health care dropped from 38 percent to 14 percent.