Practice Facilitation for Unhealthy Alcohol Use

Recruiting at 1 trial location

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

42 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on improving alcohol-related care, so it's best to ask the trial organizers for more details.

What data supports the effectiveness of the treatment Practice facilitation implementation intervention for unhealthy alcohol use?

Practice facilitation has been shown to improve the implementation of quality improvement interventions in healthcare settings, such as primary care and liver clinics, by addressing barriers and optimizing care delivery. This suggests it could be effective in enhancing alcohol-related care by ensuring that patients receive appropriate screening and treatment. ^{1 2 3 4 5}

Is practice facilitation for unhealthy alcohol use safe for humans?

The research does not provide specific safety data for practice facilitation as a treatment, but it is generally used to improve the implementation of existing safe and evidence-based alcohol-related care in primary care settings. ^{2 6 7 8 9}

How is the Practice Facilitation treatment for unhealthy alcohol use different from other treatments?

Practice Facilitation is unique because it focuses on improving the implementation of alcohol-related care in clinical settings by addressing barriers and enhancing facilitators through a clinic-centered approach. Unlike standard treatments that directly target the patient, this strategy aims to optimize the healthcare environment to better support alcohol-related interventions. ^{1 3 8 10 11}

What is the purpose of this trial?

In order to improve the quality of alcohol-related care for those with unhealthy alcohol use, the current research will use an evidence-based implementation strategy, practice facilitation, at one VA primary care site to pilot test whether practice facilitation has the potential to improve the quality of primary care-based alcohol-related care . It is hypothesized that primary care providers who take part in the practice facilitation intervention will provide higher quality substance use care to Veterans with unhealthy alcohol use compared to care pre-practice facilitation (e.g., administer evidence-based brief counseling interventions at higher rates, prescribe alcohol use disorder pharmacotherapy at higher rates, increase referrals to specialty substance use disorder clinics).

Research Team

Emily C. Williams, PhD MPH

Principal Investigator

VA Puget Sound Health Care System Seattle Division, Seattle, WA

Rachel L. Bachrach, PhD MS

Principal Investigator

VA Ann Arbor Healthcare System, Ann Arbor, MI

Eligibility Criteria

This trial is for Veterans aged 18 or older who are receiving care at a VA primary care site where the study is being conducted. It's specifically for those with unhealthy alcohol use and includes primary care staff involved in screening, as well as providers practicing at the clinic regularly.

Inclusion Criteria

I am a primary care provider who screens for alcohol use and works at the clinic weekly.

You are a veteran receiving care at a VA primary care site during the pilot testing of a new healthcare intervention.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Qualitative Interviews

Conduct qualitative interviews assessing Veteran and clinical stakeholders to understand barriers and facilitators to high-quality alcohol care

4 weeks

Focus Groups

Clinical stakeholders participate in focus groups to evaluate the acceptability and feasibility of the proposed practice facilitation intervention

4 weeks

Practice Facilitation Implementation

6 months during which practice facilitation is implemented to support the primary care clinic in improving routine, population-based screening, assessment, treatment, and follow-up for unhealthy alcohol use and AUDs

6 months

Follow-up

Participants are monitored for maintenance and effectiveness of alcohol-related care post implementation

12 months

Treatment Details

Interventions

• Practice facilitation implementation intervention

Trial Overview The study tests an implementation strategy called practice facilitation to see if it can improve how primary care handles unhealthy alcohol use. The goal is to see if this approach helps providers offer better substance use care, like more effective counseling and increased referrals to specialty clinics.

Participant Groups

Group I: Practice facilitation implementation intervention Experimental Treatment 1 Intervention

6 months during which practice facilitation is implemented to support the primary care clinic in improving routine, population-based screening, assessment, treatment, and follow-up for unhealthy alcohol use and AUDs.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Findings from Research

Practices that received more coaching-based strategies from facilitators were more successful in implementing quality improvement (QI) interventions, with those receiving over 6 coaching activities implementing a median of 17 out of 35 interventions.

The study found no significant link between the number of strategies used by facilitators and the overall number of QI interventions implemented, suggesting that the type of facilitation strategy, particularly coaching, is more critical than the quantity of strategies employed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study. Walunas, TL., Ye, J., Bannon, J., et al.[2022]

References

1. England pubmed.ncbi.nlm.nih.gov

Practice facilitation to implement alcohol-related care in Veterans Health Administration liver clinics: a study protocol. [2022]

2. England pubmed.ncbi.nlm.nih.gov

Using practice facilitation to improve alcohol-related care in primary care: a mixed-methods pilot study protocol. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Does coaching matter? Examining the impact of specific practice facilitation strategies on implementation of quality improvement interventions in the Healthy Hearts in the Heartland study. [2022]

4. Mexico pubmed.ncbi.nlm.nih.gov

[Interactive workshops as a dissemination strategy in psychology]. [2015]

5. England pubmed.ncbi.nlm.nih.gov

The role of the practice facilitators in Ontario primary healthcare quality improvement. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: Protocol of the ANTECEDENT study. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Jail and Emergency Department Utilization in the Context of Harm Reduction Treatment for People Experiencing Homelessness and Alcohol Use Disorder. [2022]

8. England pubmed.ncbi.nlm.nih.gov

Embedding brief interventions for alcohol in general practice: a study protocol for the REACH Project feasibility trial. [2021]

9. Netherlands pubmed.ncbi.nlm.nih.gov

Translating the lived experience of illicit drinkers into program guidance for cannabis substitution: Experiences from the Canadian Managed Alcohol Program Study. [2023]

10. Egypt pubmed.ncbi.nlm.nih.gov

The Impact of an Implementation Project on Primary Care Staff Perceptions of Delivering Brief Alcohol Advice. [2020]

11. United States pubmed.ncbi.nlm.nih.gov

Practice Facilitators' and Leaders' Perspectives on a Facilitated Quality Improvement Program. [2019]