Encouraging Physicians to Screen for and Intervene in Substance Use Disorders: Obstacles and Strategies for Change

REFERENCES

• 2007 . Rockville, MD Substance Abuse and Mental Health Services Administration. Results from the 2006 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-32, DHHS Publication No. SMA 07-4293)
   Google Scholar
• www.whitehousedrugpolicy.gov/publications/policy/ndcs06_data_supl/
   Google Scholar
• Fiellin , D A , Butler , R , D'Onofrio , G , Brown , R L and O'Connor , P G . 2002 . The physician's role in caring for patients with substance use disorders: implications for medical education and training , Providence, RI : Association for Medical Education and Research in Substance Abuse . In Project Mainstream: Strategic Plan for Interdisciplinary Faculty Development—Arming the Nation's Health Professional Workforce for a New Approach to Substance Use Disorders, Part II. Discipline-Specific Recommendations for Faculty Development
   Google Scholar
• Hanson , G R and Li , T K . 2003 . Public health implications of excessive alcohol consumption . JAMA , 289 ( 8 ) : 1031 – 2 .
   PubMed Web of Science ®Google Scholar
• McDonald , A J III , Wang , N and Camargo , C A Jr. 2004 . U.S. emergency department visits for alcohol-related diseases and injuries between 1992–2000 . Arch Intern Med , 164 : 531 – 7 .
   PubMed Web of Science ®Google Scholar
• Saitz , R . 2005 . Unhealthy alcohol use . N Engl J Med , 352 ( 56 ) : 596 – 607 .
   PubMed Web of Science ®Google Scholar
• Mertens , J R , Weisner , C , Ray , G T , Fireman , B and Walsh , K . 2005 . Hazardous drinkers and drug users in HMO primary care: prevalence, medical conditions, and costs . Alcohol Clin Exp Res , 29 ( 6 ) : 989 – 98 .
   PubMed Web of Science ®Google Scholar
• www.cfah.org
   Google Scholar
• Bien , T H , Miller , W R and Tonigan , J S . 1993 . Brief interventions for alcohol problems: a review . Addiction , 88 : 315 – 36 .
   PubMed Web of Science ®Google Scholar
• Fleming , M F , Barry , K L , Manwell , L B , Johnson , K and London , R . 1997 . Brief physician advice for problem alcohol drinkers: a randomized controlled trial in community-based primary care practices . JAMA , 277 : 1039 – 45 .
   PubMed Web of Science ®Google Scholar
• Dunn , C . 2003 . Brief motivational interviewing interventions targeting substance abuse in the acute care medical setting . Semin Clin Neuropsychiatry , 8 ( 3 ) : 188 – 96 .
   PubMedGoogle Scholar
• Gentilello , L M , Rivara , F P , Donovan , D M , Jurkovich , G J , Daranciang , E , Dunn , C W , Villaveces , A , Copass , M and Ries , R R . 1999 . Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence . Ann Surg , 230 ( 4 ) : 473 – 83 .
   PubMed Web of Science ®Google Scholar
• Wyatt , S A , Vilensky , W , Manlandro , J J Jr. and Dekker , M A II . 2005 . Medical education in substance abuse: from student to practicing osteopathic physician . J Am Osteopath Assoc , 105 ( 6 Suppl 3 ) : S18 – 25 .
   PubMedGoogle Scholar
• Harvard School of Public Health and The Robert Wood Johnson Foundation . 2000 . Report on public attitudes toward illegal drug use and drug treatment (telephone survey of 1,012 adults conducted by International Communications Research),. Unpublished slide presentation
   Google Scholar
• Conigliaro , J , Delos Reyes , C , Parran , T V and Schulz , J E . 2003 . “ Principles of screening and early intervention ” . In Principles of Addiction Medicine, , Third Edition , Edited by: Graham , A W , Schultz , T K , MFo-Smith , Ries , R K and Wilford , B B . Chevy Chase, MD : American Society of Addiction Medicine .
   Google Scholar
• American Medical Association . 1979 . AMA Guidelines for Physician Involvement in the Care of Substance-Abusing Patients (Statement of the Council on Scientific Affairs) , Chicago, IL : American Medical Association . reaffirmed 1989, 1999
   Google Scholar
• American Academy of Child and Adolescent Psychiatry . 1997 . Practice parameters . J Am Acad Child Adolesc Psychiatry , 36 ( Suppl ) : 140 – 56 .
   Google Scholar
• Jones , W A , Avant , R F , Davis , N , Saultz , J and Lyons , P . 2004 . Task Force Report 3. Report of the Task Force on Continuous Personal, Professional, and Practice Development in Family Medicine . Ann Fam Med , 2 : S65 – S74 .
   Google Scholar
• American Academy of Pediatrics, Committee on Substance Abuse . 1998 . Tobacco, alcohol, and other drugs: the role of the pediatrician in prevention and management of substance abuse . Pediatrics , 101 ( 1 ) : 125 – 8 . Pt 1
   PubMed Web of Science ®Google Scholar
• ACOG Committee on Ethics. ACOG Committee Opinion . 2004 . At-risk drinking and illicit drug use: ethical issues in obstetric and gynecologic practice . Obstet Gynecol , 103 ( 5 ) : 1021 – 31 . Pt 1 Number 294, 2004
   PubMedGoogle Scholar
• Coffield , A B , Maciosek , M V , McGinnis , J M , Harris , J R , Caldwell , M B , Teutsch , S M , Atkins , D , Richland , J H and Haddix , A . 2001 . Priorities among recommended clinical preventive services . Am J Prev Med , 21 ( 1 ) : 1 – 9 .
   PubMed Web of Science ®Google Scholar
• www.ahrq.gov/clinic/pocketgd.htm
   Google Scholar
• National Academy of Sciences . 2003 . Dispelling the Myths About Addiction: Strategies to Increase Understanding and Strengthen Research , Washington, D.C. : National Academies Press .
   Google Scholar
• McLellan , A T , Lewis , D C , O'Brien , C P and Kleber , H L . 2000 . Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation . JAMA , 284 : 1689 – 95 .
   PubMed Web of Science ®Google Scholar
• An , L C , Bernhardt , T S , Bluhm , J , Bland , P , Center , B , Ahluwalia , J S , Foldes , S S , Magnan , S and Manley , M . 2004 . Treatment of tobacco use as a chronic medical condition: primary care physicians' self-reported practice patterns . Prev Med , 38 ( 5 ) : 574 – 85 .
   PubMed Web of Science ®Google Scholar
• Cokkinides , V E , Ward , E , Jemal , A and Thun , M J . 2000 . Under-use of smoking-cessation treatments: results from the National Health Interview Survey . Am J Prev Med , 28 ( 1 ) : 119 – 22 .
   Web of Science ®Google Scholar
• Gunderson , E W , Levin , F R and Smith , L . 2005 . Screening and intervention for alcohol and illicit drug abuse: a survey of internal medicine housestaff . J Addict Dis , 24 ( 2 ) : 1 – 18 .
   PubMed Web of Science ®Google Scholar
• Friedmann , P D , McCullough , D , Chin , M H and Saitz , R . 2000 . Screening and intervention for alcohol problems: a national survey of primary care physicians and psychiatrists . J Gen Intern Med , 15 ( 2 ) : 84 – 91 .
   PubMed Web of Science ®Google Scholar
• http://www.cdc.gov/pcd/issues/2006/apr/05_0182htm
   Google Scholar
• Levy , S , Harris , S K , Sherritt , L , Angulo , M and Knight , J R . 2006 . Drug testing of adolescents in ambulatory medicine: physician practices and knowledge . Arch Pediatr Adolesc Med , 160 : 146 – 50 .
   PubMedGoogle Scholar
• http://www.casacolumbia.org/Absolutenm/article-files/29109.pdf
   Google Scholar
• Garnick , D , Horgan , C M , Merrick , E L , Hodgkin , D , Faulkner , D and Bryson , S . 2002 . Managed care plans' requirements for screening for alcohol, drug, and mental health problems in primary care . Am J Manag Care , 8 ( 10 ) : 879 – 88 .
   PubMed Web of Science ®Google Scholar
• Scott , M , Parthasarathy , S , Kohn , C , Hinman , A , Sterling , S and Weisner , C . 2004 . Adolescents with substance diagnoses in an HMO: factors associated with medical provider referrals to substance abuse and mental health treatment . Ment Health Serv Res , 6 ( 1 ) : 47 – 60 .
   PubMedGoogle Scholar
• Ferry , L H , Grissino , L M and Runfola , P S . 1999 . Tobacco dependence curricula in U.S. undergraduate medical education . JAMA , 282 ( 9 ) : 825 – 9 .
   PubMed Web of Science ®Google Scholar
• Isaacson , J H , Fleming , M F , Kraus , M , Kahn , R and Mundt , M . 2000 . A national survey of training programs in substance use disorders in residency programs . J Stud Alcohol , 61 : 912 – 5 .
   PubMed Web of Science ®Google Scholar
• Starr , S and Perrin , E C . 2005 . Teaching about schools during pediatric residency . Ambul Pediatr , 5 ( 3 ) : 178 – 84 .
   PubMedGoogle Scholar
• Lewis , D C , Niven , R G , Czechowicz , D and Trumble , J G . 1987 . A review of medical education in alcohol and other drug abuse . JAMA , 257 : 2945 – 8 .
   PubMed Web of Science ®Google Scholar
• Weintraub , T A , Saitz , R and Samet , J H . 2003 . Education of Prev Med residents about alcohol, tobacco, and other drug abuse . Am J Prev Med , 24 : 101 – 5 .
   PubMed Web of Science ®Google Scholar
• Popp , S M , Schwartz , K L and Schoener , E P . 1998 . Brief intervention in hazardous drinking: an important adjunct to medical school ATOD curriculum . Subst Abus , 19 ( 1 ) : 1 – 6 .
   PubMedGoogle Scholar
• Hodges , B , Inch , C and Silver , I . 2001 . Improving the psychiatric knowledge, skills, and attitudes of primary care physicians, 1950–2000: a review . Am J Psychiatry , 158 : 1579 – 86 .
   PubMed Web of Science ®Google Scholar
• Bauchner , H , Simpson , L and Chessare , J . 2001 . Changing physician behavior . Arch Dis Child , 84 : 459 – 62 .
   PubMed Web of Science ®Google Scholar
• Rivara , F P , Tollefson , S , Tesh , E and Gentilello , L M . 2000 . Screening trauma patients for alcohol problems: are insurance companies barriers? . J Trauma Inj Infect Crit Care , 48 ( 1 ) : 115 – 8 .
   PubMed Web of Science ®Google Scholar
• Rigotti , N A , Quinn , V P , Stevens , V J , Solberg , L I , Hollis , J F , Rosenthal , A C , Zapka , J G , France , E , Gordon , N , Smith , S and Monroe , M . 2002 . Tobacco-control policies in 11 leading managed care organizations: progress and challenges . Eff Clin Pract , 5 ( 3 ) : 130 – 6 .
   PubMedGoogle Scholar
• Ostbye , T , Yarnall , K SH , Krause , K M , Pollak , K I , Gradison , M and Michener , J L . 2005 . Is there time for management of patients with chronic diseases in primary care? . Ann Fam Med , 3 ( 3 ) : 209 – 14 .
   PubMed Web of Science ®Google Scholar
• Hopkins , S C , Lenz , E R , Pontes , N M , Lin , S X and Mundinger , M O . 2004 . Context of care or provider training: the impact on preventive screening practices . Prev Med , 40 : 718 – 24 .
   Web of Science ®Google Scholar
• http://www.ensuringsolutions.org/resources/resources_list.htm?cat_id=986
   Google Scholar
• Galanter , M , Keller , D S , Dermatis , H and Egelko , S . 2003 . The impact of managed care on substance abuse treatment: a report of the American Society of Addiction Medicine . J Addict Dis , 19 : 13 – 35 .
   Web of Science ®Google Scholar
• American Association of Health Plans . 2001 . Addressing Tobacco in Managed Care: A Resource Guide for Health Plans , Washington, DC : American Association of Health Plans .
   Google Scholar
• Gottschalk , A and Flocke , S A . 2005 . Time spent in face-to-face patient care and work outside the examination room . Ann Fam Med , 3 ( 6 ) : 488 – 93 .
   PubMed Web of Science ®Google Scholar
• Yarnall , K SH , Pollak , K I , Ostbye , T , Krause , K M and Michener , J L . 2003 . Primary care: is there enough time for prevention? . Am J Public Health , 93 : 635 – 41 .
   PubMed Web of Science ®Google Scholar
• Stafford , R S , Saglam , D , Causino , N , Starfield , B , Culpepper , L , Marder , W D and Blumenthal , D . 1999 . Trends in adult visits to primary care physicians in the United States . Arch Fam Med , 8 ( 1 ) : 33 – 4 .
   PubMedGoogle Scholar
• Ozer , E M , Adams , S H , Gardner , L R , Mailloux , D E , Wibbelsman , C J and Irwin , C E Jr. 2004 . Provider self-efficacy and the screening of adolescents for risky health behaviors . J Adolesc Health , 35 : 101 – 7 .
   PubMed Web of Science ®Google Scholar
• Frank , E , Rimer , B K , Brogan , D and Elon , L . 2000 . U.S. women physicians' personal and clinical breast cancer screening practices . J Womens Health Gend Based Med , 9 ( 7 ) : 791 – 801 .
   PubMedGoogle Scholar
• Frank , E and Harvey , L K . 1996 . Prevention advice rates of women and men physicians . Arch Fam Med , 5 ( 4 ) : 215 – 9 .
   PubMedGoogle Scholar
• Frank , E , Wright , E H , Serdula , M K , Elon , L K and Baldwin , G . 2002 . Personal and professional nutrition-related practices of U.S. female physicians . Am J Clin Nutr , 75 ( 2 ) : 326 – 32 .
   PubMed Web of Science ®Google Scholar
• Abramson , S , Stein , J , Schaufele , M , Frates , E and Rogan , S . 2000 . Personal exercise habits and counseling practices of primary care physicians: a national survey . Clin J Sports Med , 10 ( 1 ) : 40 – 8 .
   PubMed Web of Science ®Google Scholar
• Frank , E , Rothenberg , R , Lewis , D C and Belodoff , B F . 2000 . Correlates of physicians' prevention-related practices: findings from the Women's Physicians' Health Study . Arch Fam Med , 9 : 359 – 67 .
   PubMedGoogle Scholar
• Cornuz , J , Ghali , W A , Di Carlantonio , D , Pecoud , A and Paccaud , F . 2000 . Physicians ‘attitudes towards prevention: importance of intervention-specific barriers and physicians’ health habits . Fam Pract , 17 ( 6 ) : 535 – 40 .
   PubMed Web of Science ®Google Scholar
• Manzer , J . 2001 . Doctors' drinking reflected in their care . Medical Post (a Canadian physicians' newsletter) , 12 ( 22 ) : 37
   Google Scholar
• Danielsson , P E , Rivara , F P , Gentilello , L M and Maier , R V . 1999 . Reasons why trauma surgeons fail to screen for alcohol problems . Arch Surg , 143 : 564 – 8 .
   Google Scholar
• Marcell , A V , Halpern-Felsher , B , Coriell , M and Millstein , S G . 2002 . Physicians' attitudes and beliefs concerning alcohol abuse prevention in adolescents . Am J Prev Med , 22 ( 1 ) : 49 – 55 .
   PubMed Web of Science ®Google Scholar
• Gassman , R A . 2003 . Medical specialization, profession, and mediating beliefs that predict stated likelihood of alcohol screening and brief intervention: targeting educational interventions . Subst Abus , 24 ( 3 ) : 141 – 56 .
   PubMedGoogle Scholar
• Kahan , M , Wilson , L , Liu , E , Borsoi , D , Brewster , J M , Sobell , L C and Sobell , M B . 2004 . Family medicine residents' beliefs, attitudes and performance with problem drinkers: a survey and simulated patient study . Subst Abus , 25 ( 1 ) : 43 – 51 .
   PubMedGoogle Scholar
• Rubin , J D , Sobal , J and Moran , M T . 1990 . Health promotion beliefs and practices of fourth-year medical students . Am J Prev Med , 6 ( 2 ) : 106 – 11 .
   PubMed Web of Science ®Google Scholar
• Ferguson , L , Ries , R and Russo , J . 2003 . Barriers to identification and treatment of hazardous drinkers as assessed by urban/rural primary care doctors . J Addict Disord , 22 ( 2 ) : 79 – 90 .
   PubMed Web of Science ®Google Scholar
• Hanna , E Z . 1991 . Attitudes toward problem drinkers, revisited: patient-therapist factors contributing to the differential treatment of patients with alcohol problems . Alcohol Clin Exp Res , 15 ( 6 ) : 927 – 31 .
   PubMed Web of Science ®Google Scholar
• Saitz , R , Friedmann , P D , Sullivan , L M , Winter , M R , Lloyd-Travaglini , C , Moskowitz , M A and Samet , J H . 2002 . Professional satisfaction experienced when caring for substance-abusing patients: faculty and resident physician perspectives . J Gen Intern Med , 17 ( 5 ) : 373 – 6 .
   PubMed Web of Science ®Google Scholar
• Johnson , T P , Booth , A L and Johnson , P . 2005 . Physician beliefs about substance misuse and its treatment: findings from a U.S. survey of primary care practitioners . Substance Use & Misuse , 40 ( 8 ) : 1071 – 84 .
   PubMed Web of Science ®Google Scholar
• Fiellin , D A , Reid , M C and O'Connor , P G . 2000 . New therapies for patients with alcohol problems: application to primary care . American Journal of Medicine , 108 : 227 – 37 .
   PubMed Web of Science ®Google Scholar
• Mazmanian , P E and Davis , D A . 2002 . Continuing medical education and the physician as a learner: guide to the evidence . JAMA , 288 ( 9 ) : 1057 – 60 .
   PubMed Web of Science ®Google Scholar
• Fleming , M F , Barry , K L , Davis , A , Kahn , R and Rivo , M . 1994a . Faculty development in addiction medicine: project SAEFP, a one-year follow-up study . Fam Med , 4 : 221 – 5 .
   Google Scholar
• Satterfield , J M , Mitteness , L S , Tervalon , M and Adler , N . 2004 . Integrating the social and behavioral sciences in an undergraduate medical curriculum: The UCSF essential core . Acad Med , 79 : 6 – 15 .
   PubMed Web of Science ®Google Scholar
• Fleming , M F , Manwell , L B , Kraus , M , Isaacson , J H , Kahn , R and Stauffacher , E A . 1999 . Who teaches residents about the prevention and treatment of substance use disorders? A national survey . J of Fam Pract , 48 ( 9 ) : 725 – 9 .
   PubMed Web of Science ®Google Scholar
• Geller , A C , Lash , T L , Siegel , B , Annas , G D and Prout , M N . 2005 . The primary care pediatrician's influence on medical student's performance of smoking assessments and counseling . Prev Med , 41 ( 1 ) : 47 – 52 . Epub 2004 10
   PubMed Web of Science ®Google Scholar
• Kutob , R M , Senf , J H and Campos-Outcalt , D . 2006 . The diverse functions of role models across primary care specialties . Fam Med , 38 ( 4 ) : 244 – 51 .
   PubMed Web of Science ®Google Scholar
• Dube , C E , Goldstein , M G , Lewis , D C , Cyr , M G and Zwick , W R . 1989 . Project ADEPT: the development process for a competency-based alcohol and drug curriculum for primary care physicians . Subst Abus , 10 : 5 – 15 .
   Google Scholar
• Graham , A V , Davis , A K , Coggan , P G and Sherwood , R A . 1997 . Long-term evaluation of a substance abuse fellowship program in family medicine . Fam Med , 29 ( 3 ) : 194 – 8 .
   PubMedGoogle Scholar
• Cosmos Corporation . Findings from the Evaluation of the Faculty Development Program , Bethesda, MD : Cosmo Corporation . Unpublished report prepared for the Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Prevention
   Google Scholar
• Office , o f . 2004 . National Drug Control Policy. National Drug Control Strategy of the United States , 22 – 35 . Washington, D.C. : Executive Office of the President .
   Google Scholar
• Davis , D , O'Brien , M AT , Freemantle , N , Wolf , F M , Mazmanian , P and Taylor-Vaisey , A . 1999 . Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? . JAMA , 282 : 867 – 74 .
   PubMed Web of Science ®Google Scholar
• Bloom , B S . 2005 . Effects of continuing medical education on improving physician clinical care and patient health: a review of systematic reviews . Int J Technol Assess Health Care , 21 ( 3 ) : 380 – 5 .
   PubMed Web of Science ®Google Scholar
• Cantillon , P and Jones , R . 1999 . Does continuing medical education in general practice make a difference? . Br Med J , 318 : 1276 – 9 .
   PubMed Web of Science ®Google Scholar
• Cauffman , J G , Forsyth , R A , Clark , V A , Foster , J P , Martin , K J , Lapsys , F X and Davis , D A . 2002 . Randomized controlled trials of continuing medical education: what makes them most effective? . J Contin Educ Health Prof , 22 ( 4 ) : 214 – 21 .
   PubMedGoogle Scholar
• Poirier , M K , Clark , M M , Cerhan , J H , Pruthi , S , Geda , Y E and Dale , L C . 2004 . Teaching motivational interviewing to first-year medical students to improve counseling skills in health behavior change . Mayo Clin Proc , 79 ( 3 ) : 327 – 31 .
   PubMed Web of Science ®Google Scholar
• Lewis , D C and Faggett , W L . 1991 . Policy Report of the Physician Consortium on Substance Abuse Education (Pub. No. HRSA-P-DM-91-3) , Rockville, MD : U.S. Department of Health and Human Services, Public Health Service, Health Resources and Services Administration .
   Google Scholar
• Owen , C and Reay , R E . 2004 . Consumers as tutors—legitimate teachers? . BMC Med Educ , 20 ( 4 ) : 14
   Google Scholar
• Handmaker , N S , Hester , R K and Delaney , H D . 1999 . Videotaped training in alcohol counseling for obstetric care practitioners: A randomized controlled trial . Obstet Gynecol , 93 ( 2 ) : 213 – 8 .
   PubMed Web of Science ®Google Scholar
• Voelker , R . 2003 . Virtual patients help medical students link basic science with clinical care . JAMA , 290 ( 13 ) : 1700 – 1 .
   PubMed Web of Science ®Google Scholar
• Johnson , K B , Serwint , J R , Fagan , L M , Thompson , R E and Wilson , M H . 2005 . Computer-based documentation: effect on parent and physician satisfaction during a pediatric health maintenance encounter . Arch Pediatr Adolesc Med , 159 ( 3 ) : 250 – 4 .
   PubMedGoogle Scholar
• Babor , T F , Higgins-Biddle , J C , Higgins , P S , Gassman , R A and Gould , B E . 2004 . Training medical providers to conduct alcohol screening and brief interventions . Subst Abus , 25 ( 1 ) : 17 – 26 .
   PubMedGoogle Scholar
• Saitz , R , Sullivan , L M and Samet , J H . 2000 . Training community-based clinicians in screening and brief intervention for substance abuse problems: translating evidence into practice . Subst Abus , 21 ( 1 ) : 21 – 31 .
   PubMedGoogle Scholar
• Spandorfer , J M , Israel , Y and Turner , B J . 1999 . Primary care physicians' views on screening and management of alcohol abuse: inconsistencies with national guidelines . JFam Pract , 48 ( 11 ) : 899 – 902 .
   Web of Science ®Google Scholar
• Hansen , L J , Olivarius , N , Beich , A and Barfod , S . 1999 . Encouraging GPs to undertake screening and a brief intervention in order to reduce problem drinking: a randomized controlled trial . Fam Pract , 16 ( 6 ) : 551 – 7 .
   PubMed Web of Science ®Google Scholar
• Gomel , M K , Wutzke , S E , Hardcastle , D M , Lapsley , H and Reznik , R B . 1998 . Cost-effectiveness of strategies to market and train primary health care physicians in brief intervention techniques for hazardous alcohol use . Soc Sci Med , 47 ( 2 ) : 203 – 11 .
   PubMed Web of Science ®Google Scholar
• Leaf , P J , Owens , P L , Leventhal , J M , Forsyth , B W , Vaden-Kiernan , M , Epstein , L D , Riley , A W and Horwitz , S M . 2004 . Pediatricians' training and identification and management of psychosocial problems . Clin Pediatr (Phila) , 43 ( 4 ) : 355 – 65 .
   PubMed Web of Science ®Google Scholar
• Kaner , E F , Wutzke , S , Saunders , J B , Powell , A , Morawski , J and Bouix , J C . 2001 . WHO Brief Intervention Study Group. Impact of alcohol education and training on general practitioners' diagnostic and management skills: findings from a World Health Organization collaborative study . J Stud Alcohol , 62 ( 5 ) : 621 – 7 .
   PubMed Web of Science ®Google Scholar
• Gaither , C A , Bagozzi , R P , Ascione , F J and Kirking , D M . 1996 . A reasoned action approach to physicians' utilization of drug information sources . Pharmacy Resident , 13 ( 9 ) : 1291 – 8 .
   Google Scholar
• Westbrook , J I , Coiera , E W and Gosling , A S . 2005b . Do online information retrieval systems help experienced clinicians answer clinical questions? . Med Decis Making , 25 ( 2 ) : 315 – 21 .
   Google Scholar
• Davis , D . 1998 . Does CME work? An analysis of the effect of educational activities on physician performance or health care outcomes . Int J Psychiatry Med , 28 ( 1 ) : 21 – 39 .
   PubMed Web of Science ®Google Scholar
• Davis , D A , Thomson , M A , Oxman , A D and Haynes , R B . 1992 . Evidence for the effectiveness of CME: a review of 50 randomized controlled trials . JAMA , 2 ( 9 ) : 1135 – 6 . 268
   Web of Science ®Google Scholar
• National Institute on Alcohol Abuse and Alcoholism . 2005 . Helping patients who drink too much: a clinician's guide 2005 , Rockville, MD : National Institute on Alcohol Abuse and Alcoholism, National Institutes on Health .
   Google Scholar
• Center , f or . 1997 . Substance Abuse Treatment. A Guide to Substance Abuse Services for Primary Care Clinicians , Rockville, MD : Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration . Treatment Improvement Protocol (TIP) Series, No. 24 (DHHS Pub. SMA 97-3139)
   Google Scholar
• Cabana , M D , Rand , C S , Powe , N R , Wu , A W , Wilson , M H , Abboud , P A and Rubin , H R . 1999 . Why don't physicians follow clinical practice guidelines? A framework for improvement . JAMA , 282 ( 15 ) : 1458 – 65 .
   PubMed Web of Science ®Google Scholar
• Davis , D A and Taylor-Vaisey , A . 1997 . Translating guidelines into practice: a systematic review of theoretic concepts, practical experience and research evidence in the adoption of clinical practice guidelines . Can Med Assoc J , 157 ( 4 ) : 408 – 16 .
   PubMed Web of Science ®Google Scholar
• Hulsman , R L , Ros , W J , Winnubst , J A and Bensing , J M . 1999 . Teaching clinically experienced physicians communication skills: a review of evaluation studies . Medical Education , 33 ( 9 ) : 655 – 68 .
   PubMed Web of Science ®Google Scholar
• Thomson O'Brien , M A , Freemantle , N , Oxman , A D , Wolf , F , Davis , D A and Herrin , J . 2001 . Continuing education meetings and workshops: effects on professional practice and health care outcomes . Cochrane Database Systematic Reviews , 2 : CD003030
   Google Scholar
• Davis , D A , Ciurea , I , Flanagan , T M and Perrier , L . 2004 . on behalf of the Ontario Guidelines Advisory Committee. Solving the information overload: a letter from Canada . Medical Journal of Australia , 180 : S68 – S71 .
   PubMedGoogle Scholar
• Solomon , D H , Hashimoto , H , Daltroy , L and Liang , M H . 1998 . Techniques to improve physicians' use of diagnostic tests: a new conceptual framework . JAMA , 280 : 2020 – 7 .
   PubMed Web of Science ®Google Scholar
• Armstrong , E and Parsa-Parsi , R . 2005 . How can physicians' learning styles drive educational planning? . Acad Med , 80 ( 7 ) : 680 – 4 .
   PubMed Web of Science ®Google Scholar
• Bennett , N L , Davis , D A , Easterling , W E , Friedmann , P , Green , J S , Koeppen , B M , Mazmanian , P E and Waxman , H S . 2000 . Continuing medical education: a new vision of the professional development of physicians . Acad Med , 75 : 1167 – 72 .
   PubMed Web of Science ®Google Scholar
• Giannetti , V J , Sieppert , J D and Holosko , M J . 2002 . Attitudes and knowledge concerning alcohol abuse: curriculum implications . Journal of Health and Social Policy , 15 ( 1 ) : 45 – 58 .
   PubMedGoogle Scholar
• Rush , B R , Powell , L Y , Crowe , T G and Ellis , K . 1995 . Early intervention for alcohol use: family physicians' motivations and perceived barriers . Can Med Assoc J , 15 ( 6 ) : 863 – 9 . 152
   Google Scholar
• Bendtsen , P and Akerlind , I . 1999 . Changes in attitudes and practices in primary health care with regard to early intervention for problem drinkers . Alcohol and Alcohol Research , 34 ( 5 ) : 795 – 800 .
   PubMed Web of Science ®Google Scholar
• Kadel , F J and Vilensky , W . 1999 . Perceptions and reported practices of osteopathic physicians in diagnosing and treating addiction . J Am Osteopath Assoc , 99 ( 9 ) : 461 – 9 .
   PubMedGoogle Scholar
• Klamen , D L . 1999 . Education and training in addictive diseases . Psychiatr Clin North Am , 22 ( 2 ) : 471 – 80 . xi
   PubMed Web of Science ®Google Scholar
• Kahan , M , Wilson , L , Midmer , D , Borsoi , D and Martin , D . 2003 . Randomized controlled trial on the effects of a skills-based workshop on medical students' management of problem drinking and alcohol dependence . Subst Abus , 24 ( 1 ) : 5 – 16 .
   PubMedGoogle Scholar
• Volk , R J , Steinbauer , J R and Cantor , S B . 1996 . Patient factors influencing variation in the use of preventive interventions for alcohol abuse by primary care physicians . J Stud Alcohol , 57 ( 2 ) : 203 – 9 .
   PubMed Web of Science ®Google Scholar
• Greco , P J and Eisenberg , J M . 1993 . Changing physicians' practices . N Engl J Med , 329 ( 17 ) : 1271 – 3 .
   PubMed Web of Science ®Google Scholar
• Schwartz , J S and Cohen , S J . 1990 . Changing physician behavior , Rockville, MD : Agency for Health Care Policy and Research . In Primary Care Research: an Agenda for the 90s (conference proceedings) (AHCPR Publication 90–3460)
   Google Scholar
• Fleming , M F . 2002 . Screening, assessment, and intervention for substance use disorders in general health care settings , Providence, RI : Association for Medical Education and Research in Substance Abuse . In Project Mainstream: Strategic Plan for Interdisciplinary Faculty Development—Arming the Nation's Health Professional Workforce for a New Approach to Substance Use Disorders, Part I. Evidence Supporting the Strategic Plan
   Google Scholar
• Jamtvedt , G , Young , J M , Kristoffersen , D T , Thomson O'Brien , M A and Oxman , A D . 2003 . Audit and feedback: effects on professional practice and health care outcomes . Cochrane Database of Systematic Reviews , : CD000259 Update of Cochrane Database Syst Rev. 2000;(2):CD000259.(3)
   PubMedGoogle Scholar
• Office of National Drug Control Policy . 2005b . Report of a Leadership Conference on Medical Education in Substance Abuse, December 1–2, 2004 , Washington, DC : Executive Office of the President .
   Google Scholar
• www.ama-assn.org/ama1/pub/upload/mm/370/prin-ciplesperfmeas.pdf
   Google Scholar
• Grimshaw , J M , Eccles , M P , Walker , A E and Thomas , R E . 2002 . Changing physicians' behavior: what works and thoughts on getting more things to work . Journal of Continuing Education in the Health Professions , 22 ( 4 ) : 237 – 43 .
   PubMedGoogle Scholar
• Dickey , L L , Gemson , D H and Carney , P . 1999 . Office system interventions supporting primary care-based health behavior change counseling . Am J Prev Med , 17 : 299 – 308 .
   PubMed Web of Science ®Google Scholar
• Ozer , E M , Adams , S H , Lustig , J L , Gee , S , Garber , A K , Gardner , L R , Rehbein , M , Addison , L and Irwin , C E Jr. 2005 . Increasing the screening and counseling of adolescents for risky health behaviors: a primary care intervention . Pediatrics , 115 ( 4 ) : 960 – 8 .
   PubMed Web of Science ®Google Scholar
• Balas , E A , Weingarten , S , Garb , C T , Blumenthal , D , Boren , S A and Brown , G D . 2000 . Improving preventive care by prompting physicians . Arch Intern Med , 160 ( 3 ) : 301 – 8 .
   PubMedGoogle Scholar
• Brown , J B and McFarland , B H . 2000 . Controlled trials of CQI and academic detailing to implement a clinical practice guideline . J Qual Improv , 26 ( 1 ) : 39 – 54 .
   PubMedGoogle Scholar
• Wells , K B , Sherborne , C and Schoebaum , M . 2000 . Impact of disseminating quality improvement programs for depression in managed care . JAMA , 283 ( 2 ) : 212 – 20 .
   PubMed Web of Science ®Google Scholar
• Bungey , J B , Pols , R G , Mortimer , K P , Frank , O R and Skinner , H A . 1989 . Screening alcohol and drug use in a general practice unit: comparison of computerised and traditional methods . Community Health Stud , 13 ( 4 ) : 471 – 83 .
   PubMedGoogle Scholar
• Rushakoff , R J and Woeber , K A . 2003 . Evaluation of a “formal” endocrinology curbside consultation service: advice by means of internet, fax, and telephone . Endocrinol Pract , 9 ( 2 ) : 124 – 7 .
   PubMedGoogle Scholar
• Westbrook , J I , Gosling , A S and Coiera , E . 2005c . Do clinicians use online evidence to support patient care? A study of 55,000 clinicians . J Am Med Inform Assoc , 11 ( 2 ) : 113 – 20 .
   Web of Science ®Google Scholar
• Adatia , F and Bedard , P L . 2003 . “Palm reading”: 2. Handheld software for physicians . Can Med Assoc J , 168 ( 6 ) : 727 – 34 .
   Web of Science ®Google Scholar
• Lu , Y C , Xiao , Y , Sears , A and Jacko , J A . 2005 . A review and a framework of handheld computer adoption in healthcare . J Med Inform , 74 : 409 – 22 .
   PubMed Web of Science ®Google Scholar
• Buck , D S , Rochon , H and Turley , D P . 2005 . Taking it to the streets: recording medical outreach data on personal digital assistants . Computer, Informatics, Nursing , 23 ( 5 ) : 250 – 5 .
   PubMed Web of Science ®Google Scholar
• Criswell , D F and Parchman , M L . 2002 . Handheld computer use in U.S. family practice residency programs . J Am Med Inform Assoc , 9 ( 1 ) : 80 – 6 .
   PubMed Web of Science ®Google Scholar
• Chambers , M , Connor , S L and McElhinney , S . 2005 . Substance use and young people: the potential of technology . Psychiatr Ment Health Nurs , 12 ( 2 ) : 179 – 86 . Erratum in Psychiatr Ment Health Nurs. 2005;12(4):386
   PubMedGoogle Scholar
• Borland , R and Segan , C . 2006 . The potential of quitlines to increase smoking cessation . Drug Alcohol Rev , 15 ( 1 ) : 73 – 8 .
   Web of Science ®Google Scholar
• Katz , S J , Nissan , N and Moyer , C A . 2004 . Crossing the digital divide: evaluating online communication between patients and their providers . Am J Manag Care , 10 ( 9 ) : 593 – 8 .
   PubMed Web of Science ®Google Scholar
• Leong , S L , Gingrich , D , Lewis , P R , Mauger , D T and George , J H . 2005 . Enhancing doctor-patient communication using email: a pilot study . Journal of the American Board of Fam Pract , 18 ( 3 ) : 180 – 8 .
   PubMedGoogle Scholar
• Liederman , E M , Lee , J C , Baquero , V H and Seites , P G . 2005 . Patient-physician web messaging . J Gen Intern Med , 20 ( 1 ) : 52 – 7 .
   PubMed Web of Science ®Google Scholar
• Westberg , E E and Miller , R A . 1999 . The basis for using the Internet to support the information needs of primary care . J Am Med Inform Assoc , 6 : 6 – 25 .
   PubMed Web of Science ®Google Scholar
• Pederson , L , Blumenthal , D , Dever , A and McGrady , G . 2006 . A web-based smoking cessation and prevention curriculum for medical students: why, how, what, and what next . Drug Alcohol Rev , 25 ( 1 ) : 39 – 47 .
   PubMed Web of Science ®Google Scholar
• Bennett , N L , Casebeer , L L , Kristofco , R E and Strasser , S M . 2004 . Physicians' Internet information-seeking behaviors . J Contin Educ Health Prof , 24 ( 1 ) : 31 – 8 .
   PubMedGoogle Scholar
• Wiecha , J and Barrie , N . 2002 . Collaborative online learning: a new approach to distance CME . Acad Med , 77 ( 9 ) : 928 – 9 .
   PubMedGoogle Scholar
• Endsley , S , Kirkegaard , M and Linares , A . 2005 . Working together: communities of practice in family medicine . Fam Pract Management , 12 ( 1 ) : 28 – 32 .
   PubMedGoogle Scholar
• Fordis , M , King , J E , Ballantyne , C M , Jones , P H , Schneider , K H , Spann , S J , Greenberg , S G and Greisinger , A J . 2005 . Comparison of the instructional efficacy of Internet-based CME with live interactive CME workshops . JAMA , 294 : 1043 – 51 .
   PubMed Web of Science ®Google Scholar
• Wutoh , R , Boren , S A and Balas , E A . 2004 . eLearning: a review of Internet-based continuing medical education . J Contin Educ Health Prof , 24 ( 1 ) : 20 – 30 .
   PubMedGoogle Scholar
• Town , R , Kane , R , Johnson , P and Butler , M . 2005 . Economic incentives and physicians' delivery of preventive care: a systematic review . Am J Prev Med , 28 ( 2 ) : 234 – 40 .
   PubMed Web of Science ®Google Scholar
• McInerny , T K , Cull , W L and Yudkowsky , B K . 2005 . Physician reimbursement levels and adherence to American Academy of Pediatrics well-visit and immunization recommendations . Pediatrics , 115 ( 4 ) : 833 – 8 .
   PubMed Web of Science ®Google Scholar
• http://www.nihcm.org/publications/prevention
   Google Scholar
• American Academy of Pediatrics, Committee on Child Health Financing and Committee on Substance Abuse . 2001 . Improving substance abuse prevention, assessment, and treatment financing for children and adolescents . Pediatrics , 108 ( 4 ) : 1025 – 9 .
   PubMed Web of Science ®Google Scholar
• Bero , L A , Grilli , R , Grimshaw , J M , Harvey , E , Oxman , A D and Thomson , M A . 1998 . Getting research findings into practice—Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings . Br Med J , 317 : 465 – 8 .
   PubMed Web of Science ®Google Scholar
• www.nap.edu/catalog/11470.html
   Google Scholar
• Institute of Medicine . 2004 . Improving Medical Education. Enhancing the Behavioral and Social Science Content of Medical School Curricula. Report of the Board on Neuroscience and Behavioral Health, Committee on Behavioral and Social Science in Medical School Curricula , Washington, DC : National Academies Press . Institute of Medicine of the National Academies
   Google Scholar
• Fleming , M F , Mundt , M P , French , M T , Manwell , L B , Stauffacher , E A and Barry , K L . 2002 . Brief physician advice for problem drinkers: long-term efficacy and benefit-cost analysis . Alcohol Clin Exp Res , 26 ( 1 ) : 36 – 43 .
   PubMed Web of Science ®Google Scholar
• Poikolainen , K . 1999 . Effectiveness of brief interventions to reduce alcohol intake in primary health care populations: a meta-analysis . Prev Med , 28 ( 5 ) : 503 – 9 .
   PubMed Web of Science ®Google Scholar
• Wilk , A I , Jensen , N M and Havighurst , T C . 1997 . Meta-analysis of randomized control trials addressing brief interventions in heavy alcohol drinkers . J Gen Intern Med , 12 ( 5 ) : 274 – 83 .
   PubMed Web of Science ®Google Scholar
• Romberger , D J and Grant , K . 2004 . Alcohol consumption and smoking status: the role of smoking cessation . Biomed Pharmacother , 58 ( 2 ) : 77 – 83 .
   PubMed Web of Science ®Google Scholar
• Sullivan , M A and Covey , L S . 2002 . Current perspectives on smoking cessation among substance abusers . Curr Psychiatry Rep , 4 ( 5 ) : 388 – 96 .
   PubMedGoogle Scholar
• American Medical Association . 1981 . Drug Abuse Related to Prescribing Practices. Report to the House of Delegates , Chicago, IL : American Medical Association . reaffirmed 1991, 2001
   Google Scholar