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Background <p>Screening and treatment for unhealthy alcohol use (UAU) and alcohol use disorder (AUD) are recommended but underutilized, particularly in hospital settings.</p> Objective <p>To determine whether a comprehensive screening and treatment protocol for UAU in hospitalized patients can help reduce alcohol use.</p> Design <p>Quality improvement study at single-center safety-net hospital.</p> Participants <p>27,914 patients were admitted from 9/2022 to 9/2024, and 18,146 (65.0%) were screened with AUDIT-PC, with 1085 (6.0%) screening positive (≥ 5). Substance use navigators (SUNs) identified 257 additional patients with UAU through referral methods.</p> Intervention <p>SUNs approached eligible patients and conducted full AUDIT and brief behavioral counseling. Patients with AUDIT ≥ 12 were offered medications for AUD (MAUD) during hospitalization and at discharge.</p> Main Measures <p>Intervention delivery, 30-day return hospital encounters (readmission or emergency department), and change in AUDIT score among high-risk patients.</p> Key Results <p>Of the 1342 intervention-eligible patients, 81% were men, and the mean age was 51&#xa0;years. 54% were Caucasian, 30% Hispanic/Latinx, and 9% Black. 17% were unhoused, and 18% were uninsured. Of these 1342, 800 (59.6%) patients engaged in the intervention. The mean AUDIT score was 15 (median 14, IQR 8–21). For the 489 (61.1%) patients with AUDIT ≥ 12, 231 (47.2%) were started on medication before discharge. For the 126 patients with repeat AUDIT (25.8%), the mean reduction was 14.2 points (95% CI: −15.4, −12.2). For those with AUDIT ≥ 12, 128 (26.2%) patients had a return hospital encounter within 30&#xa0;days of discharge. Patients without return encounters had significantly larger reductions in AUDIT score than those who had return encounters (mean reduction −16.2 vs −9.1 points (difference −7.1, 95% CI: −3.1, −11.0)).</p> Conclusions <p>UAU screening and risk-stratified treatment (including pharmacotherapy) can be delivered in diverse hospitalized patients, and were accompanied by short-term changes in alcohol risk score among patients reached for follow-up.</p>

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Implementation of a Hospital-Based Screening and Treatment Program for Unhealthy Alcohol Use

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月14日

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  • Jananie Ramesh,
  • Christopher Moriates,
  • John Embers,
  • Alanna Boulton,
  • Nicole Kluz,
  • Rachel Holliman,
  • Frances Ibarra,
  • Ohenewaa Dede-Bamfo,
  • Patrick Chang,
  • Mary Velasquez,
  • Michael Pignone

摘要

Background

Screening and treatment for unhealthy alcohol use (UAU) and alcohol use disorder (AUD) are recommended but underutilized, particularly in hospital settings.

Objective

To determine whether a comprehensive screening and treatment protocol for UAU in hospitalized patients can help reduce alcohol use.

Design

Quality improvement study at single-center safety-net hospital.

Participants

27,914 patients were admitted from 9/2022 to 9/2024, and 18,146 (65.0%) were screened with AUDIT-PC, with 1085 (6.0%) screening positive (≥ 5). Substance use navigators (SUNs) identified 257 additional patients with UAU through referral methods.

Intervention

SUNs approached eligible patients and conducted full AUDIT and brief behavioral counseling. Patients with AUDIT ≥ 12 were offered medications for AUD (MAUD) during hospitalization and at discharge.

Main Measures

Intervention delivery, 30-day return hospital encounters (readmission or emergency department), and change in AUDIT score among high-risk patients.

Key Results

Of the 1342 intervention-eligible patients, 81% were men, and the mean age was 51 years. 54% were Caucasian, 30% Hispanic/Latinx, and 9% Black. 17% were unhoused, and 18% were uninsured. Of these 1342, 800 (59.6%) patients engaged in the intervention. The mean AUDIT score was 15 (median 14, IQR 8–21). For the 489 (61.1%) patients with AUDIT ≥ 12, 231 (47.2%) were started on medication before discharge. For the 126 patients with repeat AUDIT (25.8%), the mean reduction was 14.2 points (95% CI: −15.4, −12.2). For those with AUDIT ≥ 12, 128 (26.2%) patients had a return hospital encounter within 30 days of discharge. Patients without return encounters had significantly larger reductions in AUDIT score than those who had return encounters (mean reduction −16.2 vs −9.1 points (difference −7.1, 95% CI: −3.1, −11.0)).

Conclusions

UAU screening and risk-stratified treatment (including pharmacotherapy) can be delivered in diverse hospitalized patients, and were accompanied by short-term changes in alcohol risk score among patients reached for follow-up.