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Screening for problem drinking: impact on physician behavior and patient drinking habits
J Conigliaro1, R P Lofgren, B H Hanusa
1Section of General Internal Medicine, VA Pittsburgh Health Care System, Center for Research on Healthcare, University of Pittsburgh, PA 15240, USA.
Journal of General Internal Medicine
|June 13, 1998
Summary
Screening medical residents for problem drinking led to discussions about alcohol use, but advice and treatment were less frequent. Patient alcohol consumption decreased overall, suggesting screening may influence behavior.
Area of Science:
- Medical Education
- Public Health
- Substance Abuse Research
Background:
- Problem drinking among patients presents a significant challenge in healthcare settings.
- Early identification and intervention are crucial for managing alcohol-related health issues.
- Medical residents require effective strategies to address patient alcohol consumption.
Purpose of the Study:
- To evaluate the impact of a problem drinking screening tool on medical residents' practices.
- To assess the effect of this screening on patient alcohol consumption and recall of discussions.
Main Methods:
- A descriptive cohort study was conducted at a Veterans Affairs Medical Clinic.
- 714 patients were screened for problem drinking two weeks prior to their appointments.
- Physicians were notified of positive patient screenings, and patient interviews and chart reviews documented discussions and alcohol use.
Main Results:
- 28% of current drinkers screened positive for problem drinking using the Alcohol Use Disorders Identification Test (AUDIT).
- Among positive patients, 78% recalled a discussion about alcohol use, 58% received advice to reduce drinking, and 9% were referred for treatment.
- Overall alcohol consumption decreased at six months for both AUDIT-positive and AUDIT-negative patients, with problem drinking reducing from 58% to 49%.
Conclusions:
- Resident physicians frequently discussed alcohol use with patients screening positive but less often provided specific advice or treatment.
- Chart notations regarding alcohol use were less frequent for newly identified problem drinkers.
- Screening for alcohol abuse appears to positively influence patient consumption patterns.