Trial Outcomes & Findings for Records for Alcohol Care Enhancement (NCT NCT05492942)

Results Overview

The percent of new AUD diagnosis episodes that meet criteria for AUD treatment engagement among patients with a new AUD diagnosis on a randomized clinician's panel. Engagement is defined as having two or more healthcare services (inclusive of AUD medication) with a diagnosis of AUD within 34 days of meeting initiation, which is defined as having a healthcare service for AUD within 14 days of a new AUD diagnosis. A new AUD diagnosis is defined as a health service in which a patient receives a new AUD diagnosis when there has not been an AUD diagnosis during the prior 194 days, excluding diagnoses assigned in emergency department/detox. Outcome is reported at the empaneled patient level. Outcome measure time frame is based on definitions of initiation and engagement. Engagement is assessed within 34 days following treatment initiation, and initiation is assessed within 14 days of a new AUD diagnosis (34 days + 14 days =a maximum possible outcome measure time frame of 48 days).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

134 participants

Primary outcome timeframe

The outcome measure is assessed within 48 days following the date of the new AUD diagnosis, among patients empaneled to randomized clinicians.

Results posted on

2025-11-10

Participant Flow

Only clinicians were consented and enrolled. Randomization and the intervention occurred at the clinician level. Outcomes were observed among primary care patients of randomized clinicians.

Participant milestones

Participant milestones
Measure	Clinician Prompting and Decision Support, Best Practice Advisory (BPA) Access to an existing BPA for risky alcohol use and alcohol use disorder.	BPA Plus Population Health Management (BPA+PHM) Access to the existing Epic BPA for risky alcohol use and alcohol use disorder + targeted support by a population health manager (PHM). Best Practice Advisory (BPA) and Population Health Management (PHM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). Additionally, a clinician will be supported by a PHM who can access and existing registry of patients with possible or confirmed AUD to examine quality metrics for patients with an AUD on the provider panel. The PHM will circulate quarterly reports to the clinicians in this group to provide performance metric data that indicates the proportion of patients on their primary care panel who are initiating and engaging in AUD treatment. Additionally, the PHM will circulate a weekly report of higher risk patients on the clinician's panel who recently had an acute care visit for AUD and could benefit from outreach for follow-up care. PHM does not directly help clinicians with implementation of care with individual patients, and has no direct patient contact.	BPA Plus Clinical Care Management (BPA+CCM) Access to the existing Epic BPA for risky alcohol use and alcohol use disorder + targeted support by a clinician care manager (CCM). Best Practice Advisory (BPA) and Clinical Care Management (CCM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). The clinician will be supported by a CCM who will assist in identifying patients who need further assessment on the clinician patient panel. The CCM will conduct outreach to patients regarding alcohol use care, and will communicate with the clinician to help decide potential care plans, and then assist in implementing those plans for patients. The CCM has expertise on how to provide appropriate care to patients and can help patients navigate the complex care system. Further assistance by the CCM may include facilitating prescriptions for clinician sign-off, assuring refills, finding, selecting and coordinating specialty AUD care, and contacting patients to make appointments.	BPA Plus Population Health Management Plus Clinical Care Management (BPA+PHM+CCM) Access to the existing Epic BPA risky alcohol use and alcohol use disorder + targeted support by a population health manager (PHM) and clinician care manager (CCM) Best Practice Advisory (BPA) and Population Health Management (PHM) and Clinical Care Management (CCM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). Additionally, a clinician will be supported by a PHM and clinical care manager CCM. The PHM can access and existing registry of patients with possible or confirmed alcohol use disorder to examine quality metrics for patients with an alcohol use disorder on the provider panel. The PHM will circulate quarterly reports to the clinicians in this group to provide summaries of data of those who have initiated or engaged in treatment for alcohol use, as well as a weekly report of higher risk patients on their panel who recently had an acute care visit for AUD and could benefit from outreach for follow-up care. The CCM will assist in identifying patients who need further assessment, and will assist in conducting outreach and implementing care to those patients regarding alcohol use care.
Overall Study STARTED	30	36	34	34
Overall Study 12 Months	28	36	34	33
Overall Study COMPLETED	20	29	26	21
Overall Study NOT COMPLETED	10	7	8	13

Reasons for withdrawal

Reasons for withdrawal
Measure	Clinician Prompting and Decision Support, Best Practice Advisory (BPA) Access to an existing BPA for risky alcohol use and alcohol use disorder.	BPA Plus Population Health Management (BPA+PHM) Access to the existing Epic BPA for risky alcohol use and alcohol use disorder + targeted support by a population health manager (PHM). Best Practice Advisory (BPA) and Population Health Management (PHM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). Additionally, a clinician will be supported by a PHM who can access and existing registry of patients with possible or confirmed AUD to examine quality metrics for patients with an AUD on the provider panel. The PHM will circulate quarterly reports to the clinicians in this group to provide performance metric data that indicates the proportion of patients on their primary care panel who are initiating and engaging in AUD treatment. Additionally, the PHM will circulate a weekly report of higher risk patients on the clinician's panel who recently had an acute care visit for AUD and could benefit from outreach for follow-up care. PHM does not directly help clinicians with implementation of care with individual patients, and has no direct patient contact.	BPA Plus Clinical Care Management (BPA+CCM) Access to the existing Epic BPA for risky alcohol use and alcohol use disorder + targeted support by a clinician care manager (CCM). Best Practice Advisory (BPA) and Clinical Care Management (CCM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). The clinician will be supported by a CCM who will assist in identifying patients who need further assessment on the clinician patient panel. The CCM will conduct outreach to patients regarding alcohol use care, and will communicate with the clinician to help decide potential care plans, and then assist in implementing those plans for patients. The CCM has expertise on how to provide appropriate care to patients and can help patients navigate the complex care system. Further assistance by the CCM may include facilitating prescriptions for clinician sign-off, assuring refills, finding, selecting and coordinating specialty AUD care, and contacting patients to make appointments.	BPA Plus Population Health Management Plus Clinical Care Management (BPA+PHM+CCM) Access to the existing Epic BPA risky alcohol use and alcohol use disorder + targeted support by a population health manager (PHM) and clinician care manager (CCM) Best Practice Advisory (BPA) and Population Health Management (PHM) and Clinical Care Management (CCM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). Additionally, a clinician will be supported by a PHM and clinical care manager CCM. The PHM can access and existing registry of patients with possible or confirmed alcohol use disorder to examine quality metrics for patients with an alcohol use disorder on the provider panel. The PHM will circulate quarterly reports to the clinicians in this group to provide summaries of data of those who have initiated or engaged in treatment for alcohol use, as well as a weekly report of higher risk patients on their panel who recently had an acute care visit for AUD and could benefit from outreach for follow-up care. The CCM will assist in identifying patients who need further assessment, and will assist in conducting outreach and implementing care to those patients regarding alcohol use care.
Overall Study The clinician did not have an active patient panel eligible for outcome for the full 18 months	10	7	8	13

Baseline Characteristics

Records for Alcohol Care Enhancement

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Clinician Prompting and Decision Support, Best Practice Advisory (BPA) n=30 Participants Access to an existing BPA for risky alcohol use and alcohol use disorder.	BPA Plus Population Health Management (BPA+PHM) n=36 Participants Access to the existing Epic BPA for risky alcohol use and alcohol use disorder + targeted support by a population health manager (PHM). Best Practice Advisory (BPA) and Population Health Management (PHM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). Additionally, a clinician will be supported by a PHM who can access and existing registry of patients with possible or confirmed AUD to examine quality metrics for patients with an AUD on the provider panel. The PHM will circulate quarterly reports to the clinicians in this group to provide performance metric data that indicates the proportion of patients on their primary care panel who are initiating and engaging in AUD treatment. Additionally, the PHM will circulate a weekly report of higher risk patients on the clinician's panel who recently had an acute care visit for AUD and could benefit from outreach for follow-up care. PHM does not directly help clinicians with implementation of care with individual patients, and has no direct patient contact.	BPA Plus Clinical Care Management (BPA+CCM) n=34 Participants Access to the existing Epic BPA for risky alcohol use and alcohol use disorder + targeted support by a clinician care manager (CCM). Best Practice Advisory (BPA) and Clinical Care Management (CCM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). The clinician will be supported by a CCM who will assist in identifying patients who need further assessment on the clinician patient panel. The CCM will conduct outreach to patients regarding alcohol use care, and will communicate with the clinician to help decide potential care plans, and then assist in implementing those plans for patients. The CCM has expertise on how to provide appropriate care to patients and can help patients navigate the complex care system. Further assistance by the CCM may include facilitating prescriptions for clinician sign-off, assuring refills, finding, selecting and coordinating specialty AUD care, and contacting patients to make appointments.	BPA Plus Population Health Management Plus Clinical Care Management (BPA+PHM+CCM) n=34 Participants Access to the existing Epic BPA risky alcohol use and alcohol use disorder + targeted support by a population health manager (PHM) and clinician care manager (CCM) Best Practice Advisory (BPA) and Population Health Management (PHM) and Clinical Care Management (CCM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). Additionally, a clinician will be supported by a PHM and clinical care manager CCM. The PHM can access and existing registry of patients with possible or confirmed alcohol use disorder to examine quality metrics for patients with an alcohol use disorder on the provider panel. The PHM will circulate quarterly reports to the clinicians in this group to provide summaries of data of those who have initiated or engaged in treatment for alcohol use, as well as a weekly report of higher risk patients on their panel who recently had an acute care visit for AUD and could benefit from outreach for follow-up care. The CCM will assist in identifying patients who need further assessment, and will assist in conducting outreach and implementing care to those patients regarding alcohol use care.	Total n=134 Participants Total of all reporting groups
Age, Continuous	36 years STANDARD_DEVIATION 12 • n=5 Participants	34 years STANDARD_DEVIATION 11 • n=20 Participants	38 years STANDARD_DEVIATION 14 • n=40 Participants	37 years STANDARD_DEVIATION 13 • n=28 Participants	37 years STANDARD_DEVIATION 12 • n=46 Participants
Sex/Gender, Customized Female	17 Participants n=5 Participants	17 Participants n=20 Participants	27 Participants n=40 Participants	16 Participants n=28 Participants	77 Participants n=46 Participants
Sex/Gender, Customized Male	13 Participants n=5 Participants	15 Participants n=20 Participants	7 Participants n=40 Participants	18 Participants n=28 Participants	53 Participants n=46 Participants
Sex/Gender, Customized Nonbinary or Missing	0 Participants n=5 Participants	4 Participants n=20 Participants	0 Participants n=40 Participants	0 Participants n=28 Participants	4 Participants n=46 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	3 Participants n=5 Participants	4 Participants n=20 Participants	1 Participants n=40 Participants	5 Participants n=28 Participants	13 Participants n=46 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	27 Participants n=5 Participants	28 Participants n=20 Participants	33 Participants n=40 Participants	29 Participants n=28 Participants	117 Participants n=46 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants	4 Participants n=20 Participants	0 Participants n=40 Participants	0 Participants n=28 Participants	4 Participants n=46 Participants
Race (NIH/OMB) American Indian or Alaska Native	0 Participants n=5 Participants	0 Participants n=20 Participants	0 Participants n=40 Participants	0 Participants n=28 Participants	0 Participants n=46 Participants
Race (NIH/OMB) Asian	9 Participants n=5 Participants	12 Participants n=20 Participants	10 Participants n=40 Participants	6 Participants n=28 Participants	37 Participants n=46 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	0 Participants n=5 Participants	0 Participants n=20 Participants	0 Participants n=40 Participants	0 Participants n=28 Participants	0 Participants n=46 Participants
Race (NIH/OMB) Black or African American	4 Participants n=5 Participants	1 Participants n=20 Participants	1 Participants n=40 Participants	3 Participants n=28 Participants	9 Participants n=46 Participants
Race (NIH/OMB) White	15 Participants n=5 Participants	15 Participants n=20 Participants	23 Participants n=40 Participants	21 Participants n=28 Participants	74 Participants n=46 Participants
Race (NIH/OMB) More than one race	1 Participants n=5 Participants	1 Participants n=20 Participants	0 Participants n=40 Participants	1 Participants n=28 Participants	3 Participants n=46 Participants
Race (NIH/OMB) Unknown or Not Reported	1 Participants n=5 Participants	7 Participants n=20 Participants	0 Participants n=40 Participants	3 Participants n=28 Participants	11 Participants n=46 Participants

PRIMARY outcome

Timeframe: The outcome measure is assessed within 48 days following the date of the new AUD diagnosis, among patients empaneled to randomized clinicians.

Population: The overall number of participants analyzed is randomized clinicians in the study. We have listed the number of randomized clinicians in each study arm. The unit of analysis is new alcohol use disorder diagnoses among patients empaneled to randomized clinicians in each study arm. Data source: Medicaid Claims Data

The percent of new AUD diagnosis episodes that meet criteria for AUD treatment engagement among patients with a new AUD diagnosis on a randomized clinician's panel. Engagement is defined as having two or more healthcare services (inclusive of AUD medication) with a diagnosis of AUD within 34 days of meeting initiation, which is defined as having a healthcare service for AUD within 14 days of a new AUD diagnosis. A new AUD diagnosis is defined as a health service in which a patient receives a new AUD diagnosis when there has not been an AUD diagnosis during the prior 194 days, excluding diagnoses assigned in emergency department/detox. Outcome is reported at the empaneled patient level. Outcome measure time frame is based on definitions of initiation and engagement. Engagement is assessed within 34 days following treatment initiation, and initiation is assessed within 14 days of a new AUD diagnosis (34 days + 14 days =a maximum possible outcome measure time frame of 48 days).

Outcome measures

Outcome measures
Measure	Clinician Prompting and Decision Support, Best Practice Advisory (BPA) n=70 New AUD diagnosis episodes Access to an existing BPA for risky alcohol use and alcohol use disorder.	BPA Plus Population Health Management (BPA+PHM) n=137 New AUD diagnosis episodes Access to the existing Epic BPA for risky alcohol use and alcohol use disorder + targeted support by a population health manager (PHM). Best Practice Advisory (BPA) and Population Health Management (PHM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). Additionally, a clinician will be supported by a PHM who can access and existing registry of patients with possible or confirmed AUD to examine quality metrics for patients with an AUD on the provider panel. The PHM will circulate quarterly reports to the clinicians in this group to provide performance metric data that indicates the proportion of patients on their primary care panel who are initiating and engaging in AUD treatment. Additionally, the PHM will circulate a weekly report of higher risk patients on the clinician's panel who recently had an acute care visit for AUD and could benefit from outreach for follow-up care. PHM does not directly help clinicians with implementation of care with individual patients, and has no direct patient contact.	BPA Plus Clinical Care Management (BPA+CCM) n=97 New AUD diagnosis episodes Access to the existing Epic BPA for risky alcohol use and alcohol use disorder + targeted support by a clinician care manager (CCM). Best Practice Advisory (BPA) and Clinical Care Management (CCM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). The clinician will be supported by a CCM who will assist in identifying patients who need further assessment on the clinician patient panel. The CCM will conduct outreach to patients regarding alcohol use care, and will communicate with the clinician to help decide potential care plans, and then assist in implementing those plans for patients. The CCM has expertise on how to provide appropriate care to patients and can help patients navigate the complex care system. Further assistance by the CCM may include facilitating prescriptions for clinician sign-off, assuring refills, finding, selecting and coordinating specialty AUD care, and contacting patients to make appointments.	BPA Plus Population Health Management Plus Clinical Care Management (BPA+PHM+CCM) n=153 New AUD diagnosis episodes Access to the existing Epic BPA risky alcohol use and alcohol use disorder + targeted support by a population health manager (PHM) and clinician care manager (CCM) Best Practice Advisory (BPA) and Population Health Management (PHM) and Clinical Care Management (CCM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). Additionally, a clinician will be supported by a PHM and clinical care manager CCM. The PHM can access and existing registry of patients with possible or confirmed alcohol use disorder to examine quality metrics for patients with an alcohol use disorder on the provider panel. The PHM will circulate quarterly reports to the clinicians in this group to provide summaries of data of those who have initiated or engaged in treatment for alcohol use, as well as a weekly report of higher risk patients on their panel who recently had an acute care visit for AUD and could benefit from outreach for follow-up care. The CCM will assist in identifying patients who need further assessment, and will assist in conducting outreach and implementing care to those patients regarding alcohol use care.
Percent of New Alcohol Use Disorder (AUD) Diagnosis Episodes That Meet Criteria for AUD Treatment Engagement Among Patients With a New AUD Diagnosis Who Are Empaneled to Randomized Clinicians.	10 New AUD diagnosis episodes	11 New AUD diagnosis episodes	12 New AUD diagnosis episodes	30 New AUD diagnosis episodes

SECONDARY outcome

Timeframe: The outcome measure is assessed within 14 days following the date of the new AUD diagnosis, among patients empaneled to randomized clinicians.

Population: The overall number of participants analyzed is randomized clinicians in the study. We have listed the number of randomized clinicians in each study arm. The unit of analysis is new alcohol use disorder diagnoses among patients empaneled to randomized clinicians in each study arm. Data source: Medicaid Claims Data

The percent of new AUD diagnosis episodes that meet criteria for AUD treatment initiation among patients with a new AUD diagnosis on a randomized clinician's panel. Initiation is defined as having a healthcare service for AUD within 14 days of a new AUD diagnosis. A new AUD diagnosis is defined as a health service in which a patient receives a new AUD diagnosis when there has not been an AUD diagnosis during the prior 194 days, excluding diagnoses assigned in the emergency department/detox. Outcome is reported at the empaneled patient level. Outcome measure time frame is based on definitions of initiation. Initiation is assessed within 14 days of a new AUD diagnosis (14 days is the maximum possible outcome measure time frame). Outcome is assessed in Medicaid claims.

Outcome measures

Outcome measures
Measure	Clinician Prompting and Decision Support, Best Practice Advisory (BPA) n=70 New AUD Diagnosis Episodes Access to an existing BPA for risky alcohol use and alcohol use disorder.	BPA Plus Population Health Management (BPA+PHM) n=137 New AUD Diagnosis Episodes Access to the existing Epic BPA for risky alcohol use and alcohol use disorder + targeted support by a population health manager (PHM). Best Practice Advisory (BPA) and Population Health Management (PHM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). Additionally, a clinician will be supported by a PHM who can access and existing registry of patients with possible or confirmed AUD to examine quality metrics for patients with an AUD on the provider panel. The PHM will circulate quarterly reports to the clinicians in this group to provide performance metric data that indicates the proportion of patients on their primary care panel who are initiating and engaging in AUD treatment. Additionally, the PHM will circulate a weekly report of higher risk patients on the clinician's panel who recently had an acute care visit for AUD and could benefit from outreach for follow-up care. PHM does not directly help clinicians with implementation of care with individual patients, and has no direct patient contact.	BPA Plus Clinical Care Management (BPA+CCM) n=97 New AUD Diagnosis Episodes Access to the existing Epic BPA for risky alcohol use and alcohol use disorder + targeted support by a clinician care manager (CCM). Best Practice Advisory (BPA) and Clinical Care Management (CCM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). The clinician will be supported by a CCM who will assist in identifying patients who need further assessment on the clinician patient panel. The CCM will conduct outreach to patients regarding alcohol use care, and will communicate with the clinician to help decide potential care plans, and then assist in implementing those plans for patients. The CCM has expertise on how to provide appropriate care to patients and can help patients navigate the complex care system. Further assistance by the CCM may include facilitating prescriptions for clinician sign-off, assuring refills, finding, selecting and coordinating specialty AUD care, and contacting patients to make appointments.	BPA Plus Population Health Management Plus Clinical Care Management (BPA+PHM+CCM) n=153 New AUD Diagnosis Episodes Access to the existing Epic BPA risky alcohol use and alcohol use disorder + targeted support by a population health manager (PHM) and clinician care manager (CCM) Best Practice Advisory (BPA) and Population Health Management (PHM) and Clinical Care Management (CCM): A clinician will have continued access to the existing Epic BPA that provides clinical decision support and management for risky alcohol use and alcohol use disorder (AUD). Additionally, a clinician will be supported by a PHM and clinical care manager CCM. The PHM can access and existing registry of patients with possible or confirmed alcohol use disorder to examine quality metrics for patients with an alcohol use disorder on the provider panel. The PHM will circulate quarterly reports to the clinicians in this group to provide summaries of data of those who have initiated or engaged in treatment for alcohol use, as well as a weekly report of higher risk patients on their panel who recently had an acute care visit for AUD and could benefit from outreach for follow-up care. The CCM will assist in identifying patients who need further assessment, and will assist in conducting outreach and implementing care to those patients regarding alcohol use care.
Percent of New Alcohol Use Disorder (AUD) Diagnosis Episodes That Meet Criteria for AUD Treatment Initiation Among Patients With a New AUD Diagnosis Who Are Empaneled to Randomized Clinicians	32 New AUD Diagnosis Episodes	38 New AUD Diagnosis Episodes	44 New AUD Diagnosis Episodes	59 New AUD Diagnosis Episodes

SECONDARY outcome

Timeframe: Outcome measure is assessed 90 days following the date of the new AUD diagnosis, among patients empaneled to randomized clinicians.

Population: The overall number of participants analyzed is randomized clinicians in the study. We have listed the number of randomized clinicians in each study arm. The unit of analysis is new alcohol use disorder (AUD) diagnoses among patients empaneled to randomized clinicians in each study arm. Data Source: Electronic Health Record Data

Percent of new Alcohol Use Disorder (AUD) diagnosis episodes within which an AUD medication is prescribed within 90 days of the new AUD diagnosis among patients who are empaneled to randomized clinicians AUD medications include: Naltrexone, Intramuscular (IM) Naltrexone, Acamprosate, or Disulfiram. Outcome is reported at the new AUD diagnosis episode level among patients empaneled to randomized clinicians. Outcome measure time frame is assessed within 90 days of a new AUD diagnosis.