Training Primary Care Clinicians in Maintenance Care for Moderated Alcohol Use

Long-term maintenance care is needed to prevent recurrence of problematic alcohol use, yet primary care physicians receive little guidance about working with patients who have moderated or stopped their drinking. In the present pilot study, the authors examined whether a maintenance care intervention for primary care clinicians can influence practice behavior among patients with prior alcohol problems. Twelve intervention clinicians received a total of 2.25 hours of training in the maintenance care of alcohol problems in remission, a booster session, study materials and chart-based prompts at eligible patients' visits, while six control clinicians provided usual care.

Findings suggest that training and chart-based prompting can increase by nearly three-fold the likelihood that clinicians will inquire about the alcohol history with patients who have changed their drinking behavior. After the training, intervention clinicians reported significantly greater confidence in assessing and counseling alcohol patients in recovery after controlling for baseline confidence. In addition, those who ask about the patient's alcohol history were more likely to assess prior and planned alcohol treatment, assist through offers for prescriptions and treatment referral and receive higher satisfaction ratings for the visit. Future research should determine the effectiveness of maintenance care over longer periods.