Patient and provider comfort discussing substance use

Moira K. Ray, Mary Catherine Beach, Christina Nicolaidis, Dongseok Choi, Somnath (Som) Saha, Philip (Todd) Korthuis

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVES: Substance use is a prevalent issue in primary care with wide-reaching implications, particularly for the care of HIV-infected patients. This analysis identified patient and provider characteristics associated with high comfort discussing substance use in HIV primary care clinics using multivariable logistic regression. METHODS: A total of 413 patients and 44 providers completed surveys on their comfort discussing substance use. Additional independent variables from surveys included demographics, drug and alcohol use, self-efficacy, and activation for patients. Providerlevel data included demographics, training, practice descriptors, and stress levels. RESULTS: The majority of patients (76%) and providers (73%) reported high comfort. In multivariable analysis, patients with current problematic alcohol use or current drug use were half as likely to report high comfort compared to their non-substance-using peers. Higher patient self-efficacy and high levels of patient activation were independently associated with increased odds of high patient comfort. While provider-level characteristics were not associated with provider comfort, the types of patients a provider saw were. Namely, the proportion of patients on antiretroviral therapy was inversely associated with the odds of high provider comfort, whereas the proportion of patients with high patient activation was positively associated. CONCLUSIONS: Patients likely to benefit from a discussion of substance use, those with current use, are the least likely to report comfort discussing that use. Interventions that increase patient activation or self-efficacy may also increase their comfort. This research guides future interventions to increase the prevalence of discussions on substance use.

Original languageEnglish (US)
Pages (from-to)109-117
Number of pages9
JournalFamily Medicine
Volume45
Issue number2
StatePublished - Feb 2013

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Patient Participation
Self Efficacy
Primary Health Care
Alcohols
Demography
Patient Comfort
HIV
Pharmaceutical Preparations
Logistic Models
Research
Therapeutics

ASJC Scopus subject areas

  • Family Practice

Cite this

Patient and provider comfort discussing substance use. / Ray, Moira K.; Beach, Mary Catherine; Nicolaidis, Christina; Choi, Dongseok; Saha, Somnath (Som); Korthuis, Philip (Todd).

In: Family Medicine, Vol. 45, No. 2, 02.2013, p. 109-117.

Research output: Contribution to journalArticle

Ray, MK, Beach, MC, Nicolaidis, C, Choi, D, Saha, SS & Korthuis, PT 2013, 'Patient and provider comfort discussing substance use', Family Medicine, vol. 45, no. 2, pp. 109-117.
Ray, Moira K. ; Beach, Mary Catherine ; Nicolaidis, Christina ; Choi, Dongseok ; Saha, Somnath (Som) ; Korthuis, Philip (Todd). / Patient and provider comfort discussing substance use. In: Family Medicine. 2013 ; Vol. 45, No. 2. pp. 109-117.
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