Practice Facilitation for Unhealthy Alcohol Use

Not currently 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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to enhance care quality for Veterans struggling with unhealthy alcohol use. It tests a method called practice facilitation, which assists doctors in providing better alcohol-related care, such as brief counseling or necessary medications. Veterans receiving primary care at the VA and doctors who regularly see patients there participate in this trial. Veterans who frequently visit a VA primary care clinic and face unhealthy drinking habits might find this trial suitable. As an unphased trial, it offers Veterans the chance to contribute to innovative care improvements that could benefit many others in the future.

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 prior data suggests that this practice facilitation implementation intervention is safe?

Research has shown that practice facilitation, a method to improve healthcare practices, lacks specific safety data. This approach aids healthcare providers in offering better care for individuals with unhealthy alcohol use. Although direct evidence about its safety is absent, practice facilitation is not a medication or treatment; it supports healthcare teams in working more effectively.

As a supportive strategy rather than a drug, it generally does not pose direct risks like medications might. Practice facilitation has increased screening and improved care. Prospective trial participants should ask the research team any questions about what the method involves. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about practice facilitation for unhealthy alcohol use because it offers a fresh approach to tackling this issue directly within primary care settings. Unlike traditional treatments that often rely on patients seeking specialized care, this method integrates support directly into routine healthcare visits. By enhancing screening, assessment, treatment, and follow-up for alcohol use disorders right at the primary care level, it aims to catch and manage issues earlier and more effectively. This could lead to more personalized care and potentially better outcomes for patients struggling with alcohol use.

What evidence suggests that practice facilitation is effective for improving care for unhealthy alcohol use?

Research has shown that practice facilitation can greatly improve care for people with unhealthy alcohol use. One study found that this method led to a 41.6% increase in screening for alcohol problems and a 35.6% rise in brief counseling sessions. This approach is flexible and offers practical ways to better manage care in primary care settings. In this trial, participants will receive the practice facilitation implementation intervention, which helps implement proven treatments, such as Screening and Brief Intervention with Referral to Treatment (SBI/RT) and medication-assisted therapy (MAT). These findings suggest that practice facilitation can enhance care for individuals dealing with alcohol use issues. ^{1 2 6 7 8}

Who Is on the 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

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11316228/

Practice Facilitation to Address Unhealthy Alcohol Use in ... This study tested if practice facilitation improved screening for unhealthy alcohol use. It found a 41.6% increase in screening and 35.6% in ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12254629/

A Behind-the-Scenes Look at Practice Facilitation to ... PF is a versatile, flexible, and adaptable implementation approach to improve management of UAU in primary care that provides pragmatic strategies for care ...

3. clinicaltrials.gov clinicaltrials.gov/study/NCT04565899

Improving Care for Unhealthy Alcohol Use in Primary Care 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 ...

4. ascpjournal.biomedcentral.com ascpjournal.biomedcentral.com/articles/10.1186/s13722-022-00300-x

Using practice facilitation to improve alcohol-related care in ... This protocol describes a mixed-methods pilot study aimed at understanding the barriers and facilitators to evidence-based alcohol-related care in PC.

5. jabfm.org jabfm.org/content/jabfp/37/6/1027.full.pdf

Improving Care for Unhealthy Alcohol Use: Results from ... The results from our study demonstrated that a focused virtual practice facilitation intervention to support implementation of SBI/RT + MAT in.

6. withpower.com withpower.com/trial/phase-alcoholism-1-2021-cf0ec

Practice Facilitation for Unhealthy Alcohol Use Is practice facilitation for unhealthy alcohol use safe for humans? The research does not provide specific safety data for practice facilitation as a treatment, ...

7. bmcprimcare.biomedcentral.com bmcprimcare.biomedcentral.com/articles/10.1186/s12875-020-01147-4

Practice facilitation to promote evidence-based screening and ... Using mixed methods, we will assess the increase in screening for unhealthy alcohol use, increase in provision of brief counseling interventions ...

8. uptodate.com uptodate.com/contents/brief-interventions-for-unhealthy-alcohol-and-other-substance-use-in-adults

Brief interventions for unhealthy alcohol and other substance ... The goal of brief intervention for alcohol use is to decrease unhealthy alcohol use and prevent the adverse consequences of alcohol on health, ...