Bloomington, Minn. — The Agency for Healthcare Research and Quality (AHRQ) has awarded a $3.5 million grant to a consortium that includes the Institute for Clinical Systems Improvement (ICSI) to help up to 90 primary care practices in Minnesota, Wisconsin and Pennsylvania implement behavioral health and substance abuse screening and early intervention.
ICSI, a nonprofit healthcare improvement organization, will collaborate with the Pittsburgh Regional Health Initiative (PRHI), the lead organization in the initiative, and the Wisconsin Collaborative for Healthcare Quality (WCHQ) to screen patients for both depression and substance use (rather than one or the other) in their respective regions.
The goal is to improve the outcomes of patients who receive depression treatment, and reduce high-risk drinking days and drug-use days. ICSI's portion of the three-year grant is $900,000.
"This grant is exciting in two ways," said Sanne Magnan, MD, PhD, ICSI President and CEO. "It builds and expands the highly effective DIAMOND program which targets depression, and it addresses one of the leading preventable causes of illness and death—alcohol."
According to America's Health Rankings, Minnesota ranks third and Wisconsin second, respectively, in the country for prevalence of binge drinking, defined as males having five or more drinks and females having four or more drinks on one occasion.
Binge drinking has adverse health effects including increased injuries and deaths, increased aggression, fetal alcohol syndrome and liver diseases as well as contributing to many other health concerns.
The estimated excess direct medical costs in 2007 per binge drinker in Minnesota are $1,339 for adults and $1,548 for youth per the Minnesota Department of Health, but does not include indirect costs linked to decreased productivity, and increased criminal justice and social services.
The grant work builds on ICSI's DIAMOND program for depression and the SBIRT (Screening, Brief Intervention and Referral to Treatment) program supported by WCHQ, the Wisconsin Initiative to Promote Healthy Lifestyles (WIPHL) and the Substance Abuse and Mental Health Services Administration (SAMHSA).
The DIAMOND program is achieving four times as many patients with depression into remission by six months compared to typical primary care treatment. The SBIRT program delivers early intervention and treatment services for people with substance use disorders.
Among affected patients treated at 18 sites, binge drinking decreased by 20 percent, which is associated with 20 percent fewer ER visits, 33 percent fewer accidental injuries, more than a one-third reduction in hospital admissions, and a 50 percent reduction in automobile accidents and arrests.
ICSI will work to implement SBIRT into some of the clinics offering DIAMOND. Conversely, WCHQ, with help from WIPHL, will implement the DIAMOND program into clinics in Wisconsin already using SBIRT. ICSI will develop and promote implementation of quality measures for substance use screening among clinics in Minnesota, while WCHQ will similarly do so for quality measures for depression among its Wisconsin organizations.
"We're excited to be part of this initiative," says Nancy Jaeckels, ICSI Vice President in charge of the DIAMOND program. "We've learned through our experience with DIAMOND that screening patients for depression when they see their primary care physician for physical ailments often uncovers substance use problems as well.
"Studies show that treating patients for depression can help them better address their other co-morbid conditions, especially substance use where referral and coordination are often fragmented," Jaeckels added.