SUB-2 Alcohol Use Brief Intervention Provided or Offered and SUB 2a Alcohol Use Brief Intervention
The measure is reported as an overall rate which includes all hospitalized patients 18 years of age and older to whom a brief intervention was provided, or offered and refused, and a second rate, a subset of the first, which includes only those patients who received a brief intervention. The Provided or Offered rate (SUB-2), describes patients who screened positive for unhealthy alcohol use who received or refused a brief intervention during the hospital stay. The Alcohol Use Brief Intervention (SUB-2a) rate describes only those who received the brief intervention during the hospital stay. Those who refused are not included.
ACP does not support NQF measure #1663: “SUB-2 Alcohol Use Brief Intervention Provided or Offered and SUB 2a Alcohol Use Brief Intervention.” While this measure represents an important clinical concept, it is unclear whether delivering the intervention will improve alcohol consumption rates. Developers present evidence to support the benefit of performing this intervention in the outpatient setting on improvements in consumption rates, but they do not present any evidence to support the benefit of performing this intervention in the inpatient setting on improvements in alcohol consumption rates. Also, implementation has the potential to detract from care directed towards the primary indication for admission. Furthermore, “referral to Alcoholics Anonymous” should satisfy the measure requirements for providing a brief intervention. Otherwise, implementation could unfairly penalize clinicians who practice in rural areas where patients have limited access to counseling services.