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[Validity of alcohol consumption records: comparison of clinical history and telephone survey]
J M Baena Díez1, A Conesa García, R M Flores Cebrià
1Area Básica de Salud (ABS) Sant Josep, L'Hospitalet de Llobregat, Barcelona.
Objectives:
To compare primary care clinical records (PCCRs) and a telephone survey of the population group seeking health care, for the prevalence of alcohol consumption. To determine factors linked to screening and observation of alcohol consumption, and to analyse the perception and recording of medical counselling on alcohol and tobacco consumption.
Design:
Descriptive, crossover study.
Setting:
Urban Health Centre.
Participants:
Random sample of 320 patients with PCCRs, aged between 15 and 75.
Measurements And Main Results:
The PCCR was reviewed for age, sex, educational level, profession, frequency of attendance, chronic illnesses, alcohol and tobacco consumption, pathologies linked to alcohol consumption, screening and observance of this consumption as recommended by the preventive activities and health promotion programme (PAHPP), and the recording of counselling to smokers and at-risk drinkers. Later a standard questionnaire on the patients' alcohol and tobacco consumption and their perception of medical counselling was filled in by phone, 36.1% of patients consumed alcohol, according to the PCCR, which rose to 51.1% in the questionnaire (95% CI variation, 6.2-23.8). Initial screening of alcohol consumption was recorded in 67.4% of the PCCRs, with a significant association to age of 20 or over (OR = 20.5; CI, 2.9-142.6), and to education beyond primary level (OR = 8; CI, 1.7-38.5). The observation recommended by the PAHPP was correctly followed for 24.8% of patients, and was associated with being a smoker (OR = 2; CI, 1.2-3.4) and male (OR = 1.9; CI, 1.1-3.3). No significant differences were found when the under-recording in the PCCRs of alcohol counselling to at-risk drinkers (27.8% PCCRs and 35.7% questionnaire) was studied: but there were significant differences for tobacco dependency (20.7% PCCRs and 55.7% questionnaire; CI of variance: 23.6-46.4).
Conclusions:
We found considerable under-recording of alcohol consumption in the clinical records, along with little medical counselling. Preventive activities should be given priority, especially among young people, since consumption starts in adolescence, and young people, along with women and patients of low educational level, are more susceptible to medical counselling.