Alcohol abusers in primary care: readiness to change behavior

Area of Science:

• Primary Care Medicine
• Addiction Psychiatry
• Behavioral Science

Background:

• Assessing patient readiness for behavioral change is crucial for managing alcohol abuse.
• The CAGE questionnaire is a validated tool for screening alcohol abuse in primary care settings.
• Understanding the stage of change helps tailor interventions for substance abuse treatment.

Purpose of the Study:

• To assess the readiness for behavioral change in primary care patients who screen positive for alcohol abuse using the CAGE questionnaire.
• To determine if these patients are predominantly in the contemplation stage, as hypothesized.
• To inform clinical practice regarding the management of alcohol abuse in primary care.

Main Methods:

• The CAGE questionnaire was administered to 1,211 patients in urban primary care clinics.
• Patients with positive CAGE responses (n=209) completed validated instruments assessing readiness to change alcohol use.
• Quantity and frequency of alcohol consumption were also measured.

Main Results:

• 17% of patients screened positive for alcohol abuse via the CAGE questionnaire.
• Among eligible patients, 63% were in the action stage, 23% in precontemplation, and 14% in contemplation.
• Readiness to change stage distribution was consistent across different CAGE score thresholds.

Conclusions:

• Contrary to the hypothesis, most primary care patients identified with alcohol abuse are in the action stage or recovery.
• The CAGE questionnaire alone does not adequately assess the stage of change for alcohol use.
• Clinicians managing alcohol abuse in primary care would benefit from enhanced skills in relapse prevention.