Identifying available addictive disorder screening tests feasible in primary care: A systematic review

Maxime Pautrat

Keywords: Feasibility / Substance use disorders / Screening / Primary care

Background:

Addictive disorders substantially contribute to the global burden of disease. Early detection in primary care is recommended, and numerous screening tests are available. However, barriers to addictive disorder screening exist and the feasibility of using these tests in primary care is unclear.

Research questions:

This study aims to identify available addictive disorder screening tests whose feasibility has been evaluated in primary care

Method:

This systematic literature review was performed using Pubmed, PsycINFO, and the Cochrane Library databases. The search strategy included four research topics: addictive disorders, screening, primary care, and feasibility. Selection criteria included published studies evaluating the feasibility of an addictive disorder screening test in primary care. Data were extracted for each included article, and each analyzed screening test.

Results:

Of the 4911 articles selected, 20 were included and 16 screening tests were studied. Physician feasibility was evaluated with satisfaction questionnaires or qualitative studies, mainly measuring test administration time. Patient feasibility was measured using criteria including “ease of use”, comprehension, or format preference. Self-administered formats were preferred, especially electronic versions. Overall, the TAPS (Tobacco, Alcohol, Prescription medication, and other Substance use) tool provides a good balance between ease of use, brevity of administration and more extensive screening for substance use disorders.

Conclusions:

Feasibility appears to be a set of heterogeneous criteria relating to users, including comprehension or satisfaction, and practical aspects, including administration time or format preference. The criteria synthesized in this review could serve as a basis for screening test feasibility studies in primary care given the absence of feasibility study guidelines.

Points for discussion:

How can feasibility studies focusing on physicians be carried out in order to identify possible solutions for overcoming physician-related barriers?

Which innovative screening tests or formats which could improve feasibility and in turn improve screening rates? e-screening?

Who can carry out screening as part of workflow practice: nurse, primary care receptionist? Medical assistants? Other primary care models in Europe?

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