While the substance abuse epidemic has only recently caught the attention of national policy makers, the medical system has been struggling to effectively combat this scourge for years. But despite our efforts, more Americans are dying from drug overdoses than motor vehicle accidents. Clearly, this problem is in desperate need of new solutions and approaches, especially in frontline primary care clinics and emergency departments.
Patient activation, shared decision making and motivational interviewing as brief, point-of-care interventions has attracted a lot of attention and research in recent years. One of the most popular and most evidence based tools is SBIRT: Screening, Brief Intervention, and Referral to Treatment for Substance Use. I first learned about SBIRT while Program Director at Fort Hood, TX where clinicians were trained to screen all inpatients for substance abuse as well as on using motivational interviewing and SBIRT for outpatients with substance abuse issues.
Over the years, this has caught fire and now the US Army has greatly expanded the program. Every provider in my hospital just completed training in the use of SBIRT to assist patients in cutting down on problem alcohol use. Last year on iMedicalApps we reviewed a medical app called SBIRT by the Baylor School of Medicine (BSM) that became my go-to app for performing an SBIRT evaluation at the point of care (POC).
Now the University of California San Francisco (UCSF) SBIRT group with funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) has released another excellent SBIRT app that is available for free.
The medical app walks you through a typical SBIRT interaction from screening to brief intervention and referral to treatment. Unlike the BSM SBIRT medical app, the UCSF version includes an abundant amount of background information on the current epidemiology of alcohol and substance abuse, evidence for SBIRT, step by step instructions of how to perform an evaluation, links for referral sites, embedded videos and demos of SBIRT evaluations and social support and follow-up questionnaires for providers trained in SBIRT.
Evidence based medicine
There is robust evidence to support the SBIRT approach. The app uses validated screening tools such as the AUDIT, DAST and CRAFFT. The app contains multiple references (but few links) to the supporting evidence for SBIRT.
What providers would benefit from this App?
Students, residents, mid-levels, primary care providers, emergency physicians, mental health providers, any provider who may identify problem substance use and need to be able to properly screen, intervene and refer these patients. There is a free SBIRT course available through Medscape and information/self-paced modules at both UCSF and BCM.
- Utilizes a proven and established approach to substance use.
- User interface guides you through the entire SBIRT interaction.
- Includes links to referral centers and social media aspects for support.
- Includes videos/demos/case examples on SBIRT evaluations.
- Layout could be improved for providers just trying to complete an evaluation.
- Not available for Android at this time.
- No real directions on how to use the app are included, though it is pretty intuitive.
UCSF SBIRT is a welcome medical app and indispensable companion tool for any provider who has received training in SBIRT. The medical app is laid out in an intuitive fashion that can guide the novice or expert in completing an SBIRT interaction at the point of care in an efficient fashion. Both the UCSF and BSM SBIRT apps offer outstanding materials for providers who want to practice SBIRT. The UCSF app gets the upper hand on providing comprehensive content while the BSM SBIRT app is the simplest to use for just doing an SBIRT evaluation. The SBIRT approach has the potential to truly turn the tide on substance use in our country.
- Overall Score
- User Interface
Design is simple, but includes everything a provider needs to complete an SBIRT evaluation. The emphasis on providing feedback at times “gets in the way” of interacting with the primary content.
- Multimedia Usage
Validated screening tools are built into the app for POC use. The app includes links for referral/treatment centers and references/evidence on the SBIRT techniques.
App is free with funding from SAMHSA and UCSF.
- Real World Applicability
A comprehensive SBIRT app that could greatly assist many providers in altering their approach to patients with substance use and make a truly positively impact on patient care while reducing healthcare costs. SBIRT is a key tool in the current prescription opioid/heroin epidemic.
- Device Used For Review
iPhone 6S running iOS 9.3.3
- Available for DownloadiPhoneiPad