Durante, Julia C, MD

Gomez-DeJesus, Rosa, MD

Mazzaccaro, Richard J, MD, PhD

Pollack, Emily, MD

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksDepartment of PediatricsQuality Improvement: Enhancing ProviderScreening of Adolescent Substance Use WithCRAFFT QuestionnaireJulia C. Durante MDLehigh Valley Health Network, Julia.Durante@lvhn.orgEmily Pollack MDLehigh Valley Health Network, Emily.Pollack@lvhn.orgRichard J. Mazzaccaro MD, PhDLehigh Valley Health Network, Richard.Mazzaccaro@lvhn.orgRosa Gomez-DeJesus MDLehigh Valley Health Network, rosa.gomezdejesus@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/pediatricsPart of the Pediatrics CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtDurante, J. C., Pollack, E. Mazzaccaro, R. J., Gomez-Dejesus, R. (2019, June). Quality Improvement: Enhancing Provider Screening ofAdolescent Substance Use With CRAFFT Questionnaire. Poster Presented at: The LVHN Pediatric Residency scholarly activitypresentations, Allentown, PA.© 2019 Lehigh Valley Health NetworkLVHN.orgQuality Improvement: Enhancing Provider Screening of Adolescent Substance Use With CRAFFT Questionnaire Julia C. Durante, MD, Emily Pollack, MD, Richard J. Mazzaccaro, MD, PhD, Rosa Gomez de Jesus, MD Department of Pediatrics, Lehigh Valley Reilly Children’s Hospital, Allentown, PAINTRODUCTION•  Screening for substance use is an important part of  the adolescent visit, allowing providers to detect developing addictions and to offer interventions. •  This study’s goals were threefold:  1.  Obtain baseline info of pediatric providers’  screening practices 2.  Educate providers about use of the CRAFFT  screening questionnaire    CRAFFT is a validated screening tool asking questions about substance use related to riding  in a Car with a driver under the influence, using substances to Relax, Alone, to Forget, nagging  from Friends/Family, and getting in Trouble. 3.  Longitudinal follow-up of post-intervention  changes in provider screening behaviorMETHODS•  IRB exempt non-human subjects research, determined  by the LVHN IRB.•  Baseline surveys distributed to Pediatric attendings, residents and nurse practitioners practicing at a  busy, hospital-affiliated Pediatric clinic •  Interventions:    Provider education at two consecutive monthly meetings about the CRAFFT screening tool,  including:    Inclusion of “Car” question in standard clinic adolescent screening questionnaire    EPIC™ “smartphrase‘’ containing CRAFFT questionnaire for positive screens   Follow-up survey at 3 months to compare attitudes  and behaviors before and after the intervention. RESULTS•  Completed survey response rate of 23/31 (74%) for initial and 14/23 (61%) for follow-up survey (Table 1) •  Substance use screening:   At baseline, providers were very comfortable discussing substance use with adolescents   Providers were generally uncomfortable with the process of referring patients to community resources.    T his was unchanged after the intervention.•  CRAFFT Screening   Familiarity:    At baseline, 9/23 (39%) were unfamiliar with the CRAFFT screen    At 3 month follow-up, most (11/14, 79%) reported being familiar with the CRAFFT screen   Usage:     At baseline, a minority of providers (7/23, 30%) used the screening tool most or all of the time to follow-up on positive substance use screens    At 3 month follow-up, 50% of providers did so.•  “Car” Question: (Have you ever ridden in a car driven by someone (including yourself) who was “high” or had been using alcohol or drugs?)   At baseline, 14/23 (61%) reported using the Car question most or all of the time.   At follow-up, 10/14 (71%) reported asking the Car question most or all of the time. CONCLUSION•  A brief educational intervention with Pediatric attending physicians, residents, and nurse practitioners increased:   Self-reported familiarity with CRAFFT screening   Frequency of CRAFFT screen use   Frequency of asking about riding in a car with a driver under the influence. •  Providers generally feel comfortable discussing substance use with adolescents. •  Future opportunity exists to increase provider comfort with referral to  community resources.SURVEY QUESTION BASELINE FOLLOW-UPHow comfortable are you discussing alcohol and drug use with adolescents? 91.3% 92.9%How often do you review the adolescent screening questionnaire prior to or during an adolescent visit? 81.8% 85.7%How often do you directly ask adolescent patients about alcohol and drug use? 95.7% 100.0%When a patient discloses alcohol or drug use, how often do you document it in the chart? 87.0% 92.9%How confident are you in your ability to address a positive screening response for adolescent alcohol  and drug use?73.9% 92.9%How familiar are you with the community resources and referral options for adolescents who report alcohol or drug use?17.4% 21.4%When seeing adolescent patients who report alcohol or drug use, how often do you provide the patient with resources or referrals for their substance use?43.5% 42.9%How familiar are you with the CRAFFT screening tool for alcohol and substance use? 60.9% 78.6%When seeing adolescent patients who report alcohol  or drug use, how often do you use the CRAFFT screening questions?30.4% 50.0%When seeing adolescent patients, how often do you ask the patient if they have ever ridden in a car with someone who had been drinking or was high?60.9% 71.4%TABLE 1: Number reflects respondents indicating “Mostly” or “Very” or “Most of the Time” or “All of the time” as a survey response. 0%10%20%30%40%50%0102030405001020304050■ BASELINE     ■ FOLLOW-UPNever Somewhat Mostly Very Never Somewhat Mostly VeryNever Somewhat Mostly Very1. How familiar are you with the CRAFFT screening tool for alcohol and substance use?2. How often do you use the CRAFFT screening questions?3. How often do you ask the patient if they have ever ridden in a car with someone who had been drinking or was high?

Quality Improvement: Enhancing Provider Screening of Adolescent Substance Use With CRAFFT Questionnaire

https://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1439&context=pediatrics

Quality Improvement: Enhancing Provider Screening of Adolescent Substance Use With CRAFFT Questionnaire

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