Using a tablet to ask primary care patients quick questions is a valid way to screen for unhealthy alcohol and drug use, report researchers.

The study, published in the Journal of General Internal Medicine, found that while self-administered “single-item screening questions” (SISQs) may be less accurate than previously validated interviewer-administered versions, they are potentially easier to incorporate into primary care workflows and may encourage more “open disclosure of stigmatized behaviors” than face-to-face interviews.

Substance use screening is widely encouraged in health care settings but often is not done because in-person screening takes up too much clinician time.


The research team tested the self-administered SISQs at two urban primary care clinics and found that they had “adequate sensitivity and high specificity” for detecting unhealthy drug and alcohol use among the 460 study participants.

“Screening, even for alcohol use, has proven difficult to implement and sustain in regular primary care practice,” says study coauthor Richard Saitz, chair and professor of community health sciences at Boston University School of Public Health and professor of medicine at the School of Medicine.

“The SISQs are brief enough to be easily incorporated into time-pressured practice settings,” adds Saitz, who is also an internist and researcher at Boston Medical Center.

Among the study participants, 22 percent reported unhealthy alcohol use and 25 percent reported drug use in the past year. Their self-reported answers were compared to responses in longer diagnostic interviews with research assistants; some participants also underwent saliva testing.

The authors say the self-administered SISQs “may need to be followed by further assessment to guide clinical interventions,” such as determining what substances a patient was using and distinguishing those with disorders from those with risky use.

This text is published here under a Creative Commons License.
Author: Lisa Chedekel-Boston University
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