3077 — Primary Care Based Alcohol Care Management Compared to Usual VA Care: Preliminary Findings

Kyle Possemato AK (Syracuse VAMC Center for Integrated Healthcare), John Acker JD (Syracuse VAMC Center for Integrated Healthcare), Megan Aiello ML (Philadelphia VAMC Center for Integrated Healthcare), Larry Lantinga LJ (Syracuse VAMC Center for Integrated Healthcare), Steve Maisto SA (Syracuse VAMC Center for Integrated Healthcare), Dave Oslin DW (Philadelphia VAMC Center for Integrated Healthcare)

Objectives:
Alcohol misuse is the fourth leading cause of disability worldwide and is associated with increased mortality. Despite the availability of efficacious treatments, fewer than 20% of individuals with alcohol dependence are actively engaged in treatment. Therefore, improving care for veterans with alcohol dependence is a VA priority. An HSR&D funded study is currently taking place at three VA facilities in VISNs 2 and 4. This study randomizes veterans with alcohol dependence to receive treatment via Alcohol Care Management (ACM), an integrated primary care intervention, or usual care (referral to specialty SUD treatment). This poster will present changes in drinking patterns observed at the 3-month post-baseline assessment period.

Methods:
Patients completing both baseline and 3-month follow-up assessments will be included for analyses (estimated n = 50). Data will be compiled from the Penn Alcohol Craving Scale (PACS) and Time-Line Follow-Back (TLFB), measuring drinks per day. Repeated measures ANOVAs will be used to discern group differences.

Results:
Results from the participants that have completed the three month assessments thus far (n = 20) show that the two groups did not significantly differ at baseline. A significant decline in reported alcohol consumption [t (19) = 5.475, p < .001] and a trend toward decreased alcohol craving [t (19) = 7.185, p < .001] were found for all participants. A between group comparison revealed that participants in ACM had a significant decline in self-reported alcohol consumption [F (1, 19) = 9.429, p = .007] and reported a trend towards less alcohol craving than those assigned to usual care [ F (1, 19) = 3.186, p = .091].

Implications:
Preliminary findings show that veterans are benefiting from their participation in this study and that those randomized to ACM treatment are drinking less than those assigned to usual care. The initial success of ACM may be attributable to patients preferring to receive treatment within the primary care setting and decreased barriers to treatment associated with this setting.

Impacts:
These early results lend support for ACM being a promising treatment for veterans with alcohol dependence.