Strategies to increase alcohol screening in health care settings.

Although health care settings offer an ideal opportunity for identifying people who are currently experiencing or are at risk for problems with alcohol, clinicians screen fewer than one-half of their patients for alcohol use disorders. The rate of alcohol screening may be increased, however, by applying strategies shown to promote the use of screening procedures for other medical problems, such as cancer. These strategies include group education (e.g., workshops or seminars), training given by respected colleagues (i.e., opinion leaders), performance feedback, educational outreach visits to individual physicians (i.e., academic detailing), and financial incentives or penalties. Using clinic-based system protocols (e.g., patient questionnaires) can help make the implementation of alcohol screening in clinical practice both efficient and effective. Although incorporating alcohol screening into other high-priority clinical activities and screening programs remains a challenge, routine alcohol screening as a standard of care for all patients is receiving increased acceptance.