Implementation of screening, brief intervention, and referral to treatment (SBIRT) utilizing the CRAFFT+N among pediatric patients at an outpatient psychiatric practice
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引用次数: 0
Abstract
Background
Substance use among adolescents poses a significant public health challenge, with escalating rates over recent decades contributing to preventable morbidity and mortality. Despite its prevalence, only a fraction of affected individuals receive intervention, emphasizing the need for comprehensive healthcare strategies. The CRAFFT is a common tool used to evaluate substance use in youths, but limited studies have examined the innovative CRAFFT+N, which includes a nicotine screen. Thus, this study aimed to evaluate the feasibility and fidelity of pediatric SBIRT in an outpatient psychiatric setting through retrospective chart review, and secondary aims were to explore rates of pediatric substance use and associations with psychiatric variables and modality of visits, in addition to trends over time.
Methods
A retrospective chart review of electronic health record data was completed. Chi-squared analyses were used to compare which psychiatric diagnoses and psychotropic medications were associated with positive CRAFFT+N scores.
Results
A total of 455 patient encounters were reviewed, revealing concerning rates of substance and nicotine use, with approximately 20 % screening positive on the CRAFFT+N. Depressive disorders (p < 0.001), OCD (p = 0.012), and neurodevelopmental disorders (p = 0.015) were associated with positive CRAFFT scores. Positive nicotine scores were associated with bipolar disorders (p < 0.001), psychotic disorders (p = 0.001), and other psychiatric disorders (p = 0.039). Mood stabilizers were the only medication class associated with positive CRAFFT+N scores (both p < 0.001).
Conclusions
The new CRAFFT+N tool can be used to implement SBIRT into the workflow in an outpatient setting interested in assessing substance use in those aged 12–21 years.
期刊介绍:
Archives of Psychiatric Nursing disseminates original, peer-reviewed research that is of interest to psychiatric and mental health care nurses. The field is considered in its broadest perspective, including theory, practice and research applications related to all ages, special populations, settings, and interdisciplinary collaborations in both the public and private sectors. Through critical study, expositions, and review of practice, Archives of Psychiatric Nursing is a medium for clinical scholarship to provide theoretical linkages among diverse areas of practice.