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Brief training increases pediatrician screening for drug abuse, mental health

Although pediatrician training improved the rates of assessment, researchers said the increases were more modest than should be expected.

By
Stephen Feller
After training sessions, pediatricians were at least 10 times more likely to assess adolescent patients for substance abuse and mental health issues. Researchers suggest time constraints and a lack of training are to blame for the low number of doctors doing the assessments. Photo by Image Point Fr/Shutterstock
After training sessions, pediatricians were at least 10 times more likely to assess adolescent patients for substance abuse and mental health issues. Researchers suggest time constraints and a lack of training are to blame for the low number of doctors doing the assessments. Photo by Image Point Fr/Shutterstock

BETHESDA, Md., Nov. 4 (UPI) -- A few short training sessions can increase the frequency of pediatricians assessing patients for substance abuse and mental health issues, according to a newly released study.

The study showed that more pediatricians employ screening, brief intervention, and referral to treatment, or SBIRT, techniques more often if they've received training on them, rather than simply being aware they exist. SBIRT has been shown in other studies to be effective at reducing heavy drinking in adults.

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Underage drinking and drug use often coexist with mental health problems, researchers said, making identifying issues and preventing their development more important.

The researchers observed three groups in the study, two of which had been trained to use SBIRT, finding the number of interventions increased, but the increase was relatively modest.

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"Overall pediatrician attention to behavioral health concerns was still low [in the study]," said Dr. Constance Weisner, a researcher at the University of California San Francisco, in a press release. "Embedding non-physician clinicians in primary care could be a cost-effective alternative to pediatricians providing these services, and future analyses of the study data will examine patient outcomes and cost-effectiveness of the two SBIRT modalities."

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Researchers recruited 47 pediatricians to work with 1,871 patients between the ages of 12 and 18 years old between November 2011 and October 2013.

Two of the three groups of pediatricians in the study were trained to use SBIRT: A pediatrician-only group had three 60-minute training sessions, conducting assessments and interventions themselves; while the other group had one training session and then assessed patients as needed and referred them as necessary to psychologists "embedded" in their practices.

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A third group of "usual care" pediatricians was given access to the same clinical guidelines and tools as the other pediatricians but did not receive training.

Patients in the first two groups were more likely to be assessed -- 16 percent of the pediatrician-only patients and 24.5 percent of the peditrician-and-psychologist patients, as compared with just 1.5 percent of patients in the usual care group.

In the study, published in JAMA Pediatrics, researchers write that despite higher likelihood of patients being assessed if their pediatricians received SBIRT training, the low number of assessments suggests "lingering barriers to having pediatricians fully address substance use in primary care."

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Despite this, Dr. George F. Koob, director of the National Institute on Alcohol Abuse and Alcoholism, said the research will help in developing strategies to improve use of SBIRT techniques in pediatric practices.

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