Integrating Screening, Brief Intervention and Referral to Treatment for Substance Abuse Into Prenatal Care [3L]. (May 2018)

• Record Type: Journal Article
• Authors: Hostage, Jean Chavez; Brock, Julia; Craig, Wendy; Sepulveda, Debra
• Is Part Of: Obstetrics and gynecology. Volume 131(2018)Supplement 1
• Publication Date: 2018-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000533542.36412.ff
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Universal screening for substance abuse during pregnancy including brief intervention and referral to treatment (SBIRT) is recommended by ACOG. Here we present the implementation of SBIRT to facilitate clinical intervention and collect data about substance abuse during prenatal care. METHODS: A literature-based SBIRT instrument was developed and approved by regional clinicians. An EPIC team integrated the tool into the electronic health record (EHR) and built reports to display aggregate data. SBIRT is performed by a clinical social worker in a resident clinic and at nursing intake in a separate generalist and maternal fetal medicine (MFM) practice. Data reports included substance use by parents, partners, and patient (past and present use); a positive screen was defined as a "yes" response to any question from patients screened for the first time from June 2017 to September 2017. RESULTS: As of September 2017, 49% and 72% of all patients were screened in the MFM and generalist practice, respectively. Forty-six percent of new patients were screened in the resident clinic. In the resident clinic, MFM, and generalist practice from June 2017 to September 2017, 43% (n=34), 41% (n=35), and 32% (n=29) screened positive, respectively. Thirty-eight percent (n=30), 10% (n=9), and 10% (n=9) reported past or present substance abuse. CONCLUSION: Integrating universal SBIRT into prenatal care at disparate locations using EHR requires a multi-disciplinary approach. The SBIRT tool facilitates universal, reportable substance abuse screening. The tool has been expanded to quantify use and report interventions. Future reports will characterize substance abuse in our prenatal practices and inform intervention strategies in this population.