Physician knowledge of the CAGE alcohol screening questions and its impact on practice

A cross-sectional survey of physicians (n = 301) and patients (n = 321) at a university-based department of medicine was completed to determine physician's ability to list CAGE alcohol screening questions and how this knowledge is associated with practice patterns. Forty-five percent of the physicians had heard of the CAGE, but only 14% could list all four of the questions correctly. Physicians who knew the CAGE were more likely to report counseling and referral of their patients who abuse alcohol. However, as assessed by patient interview and chart review, patients with an alcohol abuse problem were no more likely to have been recognized by or to have received more aggressive care from residents who knew the CAGE than patients cared for by residents who did not know the CAGE. Knowledge of an alcohol screening test is not sufficient to change physician practice related to care of patients with an alcohol abuse problem. More attention must be directed towards the development of effective strategies which integrate into clinical practice screening and initial treatment of patients who abuse alcohol.