Richard Saitz, MD, MPH
Acknowledgment: The author thanks Dr. Jeffrey H. Samet and anonymous peer reviewers who critically reviewed the manuscript, which led to substantial improvements.
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M09-2561.
Requests for Single Reprints: Richard Saitz, MD, MPH, Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, 801 Massachusetts Avenue, 2nd Floor, Boston, MA 02118; e-mail, firstname.lastname@example.org.
Saitz R. Candidate Performance Measures for Screening for, Assessing, and Treating Unhealthy Substance Use in Hospitals: Advocacy or Evidence-Based Practice?. Ann Intern Med. 2010;153:40-43. doi: 10.7326/0003-4819-153-1-201007060-00008
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Published: Ann Intern Med. 2010;153(1):40-43.
This article has been corrected. For original version, click â€œOriginal Version (PDF)â€ in column 2.
The Joint Commission recently proposed candidate performance measures addressing unhealthy substance use in hospitalized patients. The proposed measures of screening and brief intervention (SBI) assume that interventions that work in one setting (primary care outpatient practice) would work in another (hospital); treatment would have the same benefits for persons identified by screening as for those with symptoms who seek help; treatments that work for persons less severely affected by substance use would also work for those with more severe illness; and an approach that works for nondependent, unhealthy alcohol use would work for drug use. However, these assumptions extrapolate evidence of the effectiveness of SBI for primary care outpatients with nondependent, unhealthy alcohol use to the inpatient setting, persons with dependence, and other substances. Although quality of care for unhealthy substance use in all medical settings needs to improve, the evidence base for SBI in the hospital is too limited for the implementation of performance measures assessing this care.
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