Percent of Patients/Clients Assessed for Substance Use and/or Tobacco Use in the Past 12 Months
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Definition
Substance use and smoking can negatively impact the well-being of HIV-infected persons in a variety of ways. Clinicians should routinely assess HIV-infected patients’ substance use and smoking status, and readiness to quit.
Alcohol and drug use lead to disinhibition of lifestyle choices, and can:
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Increase an individual’s risk of HIV infection and re-infection
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Impede a patient’s ability to seek and adhere to HIV treatment
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Lead to health care problems that further complicate HIV care
Detecting substance use early means that patients gain access to:
Smoking is much more prevalent among HIV-infected persons than in the general population; more than 50 percent of HIV-infected patients are estimated to be current smokers. Smoking poses unique risks to HIV-infected patients, including increased risk of HIV-associated pulmonary infections.
Formulas:
Substance Use
The number of patients/clients with at least one HIV primary care visit in the past 12 months who have also had a substance use screen in the past 12 months. Divide by the total number of patients/clients with at least one HIV primary care visit in the past 12 months. Multiply by 100 to calculate percent.
Tobacco Use The number of patients/clients with at least one HIV primary care visit in the past 12 months who have also had a tobacco use screen in the past 12 months. Divide by the total number of patients/clients with at least one HIV primary care visit in the past 12 months. Multiply by 100 to calculate percent.
Goal
Greater than 90 percent of patients/clients with at least one HIV primary care visit in the past 12 months will also have a documented substance use and/or tobacco screen in the past 12 months.
Data Collection Plan
Collect data monthly (or at the frequency established for your quality improvement effort). Identify your sample (patients who had HIV primary care visits in the previous 12 months) and count the number of patients within that sample who also had a substance use or tobacco use screening. Divide by the total number of patients with at least one HIV primary care visit in the past 12 months. Multiply by 100 to calculate percent.
Screening definitions:
A substance use screen includes documentation of discussion of substance use, past and current, in the HIV primary care record. A tobacco screen includes documentation of discussion of tobacco use.
The National HIVQUAL Project’s Minimum Sample Table will help you determine the number of records to include in your sample. The Research Randomizer can generate a random number series to help you select which records to review.
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