Provision of chronic disease preventive care in community substance use services: client and clinician report

Introduction: People with substance use problems have a higher prevalence of modifiable health risk behaviors. Routine clinician provision of preventive care may be effective in reducing such health behaviors. This study aimed to examine clinician provision of preventive care to clients of community substance use treatment services. Methods: A cross-sectional survey was undertaken with 386 clients and 54 clinicians of community substance use treatment services in one health district in New South Wales, Australia. Client- and clinician-reported provision of three elements of care (assessment, brief advice and referral) for three health risk behaviors (tobacco smoking, insufficient fruit and/or vegetable consumption and insufficient physical activity) was assessed, with associations with client characteristics examined. Results: Provision was highest for tobacco smoking assessment (90% client reported, 87% clinician reported) and brief advice (79% client reported, 80% clinician reported) and lowest for fruit and vegetable consumption (assessment 23%, brief advice 25%). Few clients reported being offered a referral (< 10%). Assessment of physical activity and brief advice for all behaviors was higher for clients residing in rural/remote areas. Conclusion: Assessment and brief advice were provided to the majority of clients for smoking, but sub-optimally for the other behaviors. Further investigation of barriers to the provision of preventive care within substance use treatment settings is required, particularly for referral to ongoing support