Screening and Brief Interventions for Alcohol Use During Pregnancy: Practices Among US Primary Care Clinicians, DocStyles 2019

Introduction Alcohol use during pregnancy can cause birth defects and devel-opmental disabilities. From 2018 through 2020, 13.5% of preg-nant women reported current drinking. The US Preventive Ser-vices Task Force recommends evidence-based tools (eg, AUDIT -C and SASQ) for implementing screening and brief interventions to reduce excessive alcohol use among adults, including pregnant people, for whom any alcohol use is considered excessive. Methods We used DocStyles 2019 data to conduct a cross-sectional analys-is to examine current screening and brief intervention practices that primary care clinicians conduct among pregnant patients; clinicians??? confidence levels in conducting screening, brief inter-ventions, and referral to treatment; and the documentation of brief interventions in the medical record. Results A total of 1,500 US adult medicine clinicians completed the entire survey. Among the respondents who conduct screening (N = 1,373) and brief interventions (N = 1,357) in their practice, nearly all reported implementing screening (94.6%) and brief interven-tions (94.9%) with their pregnant patients for alcohol use, but few-er than half felt confident about conducting their screening prac-tices (46.5%). Two-thirds (64%) reported using a tool that met the criteria recommended by the US Preventive Services Task Force (USPSTF). Over half documented brief interventions in electronic health record notes (51.7%) or designated space (50.7%). Conclusion Pregnancy presents a unique opportunity for clinicians to incor-porate screening into routine obstetric care and encourage behavi-or change among patients. Most providers reported always screen-ing their pregnant patients for alcohol use, but fewer used evidence-based USPSTF-recommended screening tools. In-creased clinician confidence in screening and brief intervention, the use of standardized screening tools tailored to pregnant people, and maximal use of electronic health record technology may en-hance the benefits of their application to alcohol use, which ulti-mately can reduce adverse outcomes associated with alcohol use during pregnancy.