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Screening Could Make Inroads in Pediatricians' Offices

November 12, 2008
by Gary A. Enos, Editor
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Evidence continues to indicate that primary care offices could serve as effective sites for identifying alcohol use problems that might require specialty services. One of the latest studies offers the somewhat surprising finding that adults could be screened successfully in the offices of their children’s pediatricians.

Published in the November issue of Pediatrics, the study conducted at three pediatric clinics in New England found that most parents would be completely comfortable with being screened for alcohol problems by their child’s pediatrician, or through a computer or paper-and-pencil survey. Both parents who were not found to have alcohol problems through use of a questionnaire and those who were found to have alcohol problems said they would generally be comfortable with this screening, though the group found to have problems was slightly less supportive of the idea overall.

Lead study author Celeste Wilson, MD, a pediatrician with Children’s Hospital Boston and Harvard Medical School, says some procedural details will likely need to be worked out before this kind of screening becomes routine in pediatricians’ offices. But she also points out that pediatricians already ask parents about a number of family health indicators that could affect their young patients’ well-being, from smoking in the home to domestic violence.

“I see this as a very powerful relationship, that of the parent and the pediatrician,” Wilson says.

What might tend to confound pediatricians is the question of what resources they can tap into at the community level if some of their patients’ parents screen positive for an alcohol problem. This is where the role of specialty addiction treatment providers in a community could surface.

“I do think it would potentially be quite helpful if addiction treatment professionals made outreach to pediatric providers,” Wilson says. “Pediatric providers in offices would actually welcome that. One of the concerns is that pediatricians don’t really know what’s out there.”

The study, funded by the Robert Wood Johnson Foundation, cites an 11% likelihood that a screening conducted at a visit to the pediatrician will indicate a positive result. That is in line with positive screening rates derived in other primary care settings.

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