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Alcohol screening scores and medication nonadherence
Chris L Bryson1, David H Au, Haili Sun
1Health Services Research & Development Northwest Center of Excellence, Veterans Affairs Puget Sound Health Care System, and University of Washington, Seattle, Washington 98101, USA.
Annals of Internal Medicine
|December 3, 2008
Summary
Alcohol misuse is linked to higher rates of medication nonadherence in veterans. Screening for alcohol use can help identify patients at risk for not taking their medications as prescribed.
Area of Science:
- Clinical Medicine
- Public Health
- Pharmacology
Background:
- Medication nonadherence is a significant issue with adverse health outcomes.
- Alcohol misuse is a potential, yet understudied, risk factor for medication nonadherence.
Purpose of the Study:
- To investigate the association between alcohol misuse, identified via a screening tool, and medication nonadherence in veteran primary care patients.
- To determine if a dose-response relationship exists between alcohol misuse severity and medication nonadherence risk.
Main Methods:
- Secondary analysis of prospective cohort data from 7 Veterans Affairs primary care clinics (1997-2000).
- Utilized the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) for alcohol misuse screening.
- Measured medication adherence (≥80% availability) from pharmacy records for statins, oral hypoglycemics, and antihypertensives.
Main Results:
- Increased alcohol misuse severity (higher AUDIT-C scores) correlated with higher rates of nonadherence for statins and antihypertensives.
- For statin adherence, the two highest alcohol misuse groups showed significantly lower adherence (58% and 55%) compared to non-drinkers (66%).
- For antihypertensive adherence, the three highest alcohol misuse groups showed lower adherence (61%, 60%, 56%) compared to non-drinkers (64%). No significant association was found for oral hypoglycemics.
Conclusions:
- Alcohol misuse, as indicated by the AUDIT-C screening tool, is associated with an increased risk of medication nonadherence.
- Findings suggest a potential link between alcohol consumption levels and adherence to critical medications like statins and antihypertensives.
- Limitations include the observational nature of the study, precluding causal inference, and potential generalizability issues to other populations.
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