Substance Use Screening
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| Performance Measure: Substance Use Screening - OPR-Related Measure: Yes |
Percentage of new clients [ 1 ] with HIV infection who have been screened [ 2 ] for substance use (alcohol & drugs) in the measurement year
Number of new HIV-infected clients who were screened for substance use within the measurement year
Number of HIV-infected clients who:
- were new during the measurement year; and
- had a medical visit with a provider with prescribing privileges [ 3 ] at least once in the measurement year
None
- Is the client HIV-infected? (Y/N)
- If yes, was the client new to the program during the reporting period? (Y/N)
- If yes, was the client screened for substance use during the measurement year? (Y/N)
- Electronic Medical Record/Electronic Health Record
- CAREWare, Lab Tracker or other electronic data base
- HIVQUAL reports on this measure for grantee under review
- Medical record data abstraction by grantee of a sample of records
- Billing records
| TOP |
| National Goals, Targets, or Benchmarks for Comparison |
IHI Goal: 90% [ 4 ]
National HIVQUAL Data [ 5 ]
| |
2003 |
2004 |
2005 |
2006 |
2007 |
| Top 10% |
100.0% |
100.0% |
100.0% |
100.0% |
100.0% |
| Top 25% |
92.3% |
100.0% |
100.0% |
100.0% |
100.0% |
| Mean* |
73.4% |
76.5% |
78.9% |
81.4% |
80.6% |
*from HAB data base
| TOP |
| Outcome Measures for Consideration |
- Substance use-related mortality rates
- Rate of substance use-related hospitalizations
- Rate of substance use referrals
| TOP |
| Basis for Selection and Placement in Group 3 |
Patients living with HIV infection must often cope with multiple social, psychiatric, and medical issues.
The measure was placed in Group 3 because the feasibility of data collection can vary considerably across grantees.
| TOP |
| US Public Health Service Guidelines |
"Patients living with HIV infection must often cope with multiple social, psychiatric, and medical issues. Thus, the (initial) evaluation should also include assessment of substance abuse, economic factors, social support, mental illness, co-morbidities, and other factors that are known to impair the ability to adhere to treatment and to alter outcomes. Once evaluated, these factors should be managed accordingly." [ 6 ]
[1] "Clients" includes all clients aged 13 years or older.
[2] The purpose of screening is to identify past or current substance use that negatively impacts linkage to care and health care in general. A substance use screen includes documentation of past and current substance use and treatment in the HIV primary care record. Screening can be provided by any member of the multidisciplinary primary care team.
[3] A "provider with prescribing privileges" is a health care professional who is certified in their jurisdiction to prescribe medications.
[4] IHI Measure reads, "Percent of Patients/Clients Assessed for Substance Use and/or Tobacco Use in the Past 12 Months."
(http://www.ihi.org/IHI/Topics/HIVAIDS/HIVDiseaseGeneral/Measures/PercentofPatientsClientsAssessedfor
SubstanceUseandorTobaccoUseinthePast12Months.htm)
[5] Substance Use Screening
(http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf)
[6] Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents (p. 13)
(http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf)
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