Alcohol and Health Implementation Checklist

Provide the (insert name of screening here...) screening to all patients 18 years and older.
When giving the screening, let patients know, "we are using this screening tool as part of a quality improvement project that our clinic is working on."
Advise patients to answer each question and give the form to the Medical Assistant when s/he takes them to the exam room.

Ask the patient for their screening document.
Enter the total score results of the three completed AUDIT-C questions into the EMR. Patients whose score is as follows will get an Alcohol and Health brochure attached to their clipboard:
- Female patients or any patient over 65 years old with a score of 3 or more
- Male patients who score 4 or more
Ensure the completed screener w/ the score noted is seen by the Provider as they enter the patient's exam room.
Give patients who score 7 or more on the AUDIT-C the Alcohol Symptom Checklist and a pen to complete in the exam room while waiting for the clinician.

If patient has a positive AUDIT-C score: The screener and an Alcohol and Health Brochure will be attached to their clipboard.
- Female patients or any patient over 65 years old with a score of 3 or more
- Male patients who score 4 or more
If a patient scores 7 or more on the AUDIT-C, in addition to the Alcohol and Health brochure, they will have an Alcohol Symptom Checklist in the exam room.
When a patient has a positive AUDIT-C score, consider the following:
- Determine if a patient at-risk drinking or high-risk drinking
- Provide brief preventative counseling utilizing the Alcohol and Health brochure
- Review the Alcohol Symptom checklist use Motivational Interviewing to assess for recurrent symptoms, the patient's relationship with alcohol, how it is affecting their lives, and the practicality of an Alcohol Use Disorder diagnosis:
  - Mild: 2-3 Symptoms
  - Moderate: 4-5 Symptoms
  - Severe: >5 Symptoms
- Implementing Shared Decision-Making with the patient. Discuss the five treatment options for addressing AUD:
  - Medications that address brain changes of AUD
  - 1:1 or couples counseling
  - Peer Support
  - Specialty addiction treatment
  - Self-guided change
- Provide the Decision Aid for them to take home and review. Assure the patient you are there to support them in their decision.
- Follow up in 2 weeks to review their thoughts.