| Alcohol screening and brief counseling in a primary care hypertensive population: a quality improvement intervention. | |
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MedLine Citation:
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PMID: 18422825 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To determine the effect of an intervention to improve alcohol screening and brief counseling for hypertensive patients in primary care. DESIGN: Two-year randomized, controlled trial. SETTING/PARTICIPANTS: Twenty-one primary care practices across the United States with a common electronic medical record. INTERVENTION: To promote alcohol screening and brief counseling. Intervention practices received site visits from study personnel and were invited to annual network meetings to review the progress of the project and share improvement strategies. MEASUREMENTS: Main outcome measures included rates of documented alcohol screening in hypertensive patients and brief counseling administered in those diagnosed with high-risk drinking, alcohol abuse or alcohol dependence. Secondary outcomes included change in blood pressure among patients with these diagnoses. FINDINGS: Hypertensive patients in intervention practices were significantly more likely to have been screened after 2 years than hypertensive patients in control practices [64.5% versus 23.5%; adjusted odds ratio (OR) = 8.1; 95% confidence interval (CI) 1.7-38.2; P < 0.0087]. Patients in intervention practices diagnosed with high-risk drinking, alcohol abuse or alcohol dependence were more likely than those in control practices to have had alcohol counseling documented (50.5% versus 29.6%; adjusted OR = 5.5, 95% CI 1.3-23.3). Systolic (adjusted mean decline = 4.2 mmHg, P = 0.036) and diastolic (adjusted mean decline = 3.3 mmHg, P = 0.006) blood pressure decreased significantly among hypertensive patients receiving alcohol counseling. CONCLUSIONS: Primary care practices receiving an alcohol-focused intervention over 2 years improved rates of alcohol screening for their hypertensive population. Implementation of alcohol counseling for high-risk drinking, alcohol abuse or alcohol dependence also improved and led to changes in patient blood pressures. |
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Authors:
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Heather Liszka Rose; Peter M Miller; Lynne S Nemeth; Ruth G Jenkins; Paul J Nietert; Andrea M Wessell; Steven Ornstein |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2008-04-16 |
Journal Detail:
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Title: Addiction (Abingdon, England) Volume: 103 ISSN: 0965-2140 ISO Abbreviation: Addiction Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-10-14 Completed Date: 2009-06-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9304118 Medline TA: Addiction Country: England |
Other Details:
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Languages: eng Pagination: 1271-80 Citation Subset: IM |
Affiliation:
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Department of Family Medicine, Medical University of South Carolina, Charleston, SC 29425, USA. liszkah@musc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Alcoholism
/
diagnosis*,
therapy Algorithms Counseling / methods* Female Humans Hypertension* / therapy Male Middle Aged Odds Ratio Physician's Practice Patterns Primary Health Care Risk Assessment United States |
| Grant Support | |
ID/Acronym/Agency:
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P50 AA010761/AA/NIAAA NIH HHS; R25 AA015066/AA/NIAAA NIH HHS |
| Comments/Corrections | |
Comment In:
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Addiction. 2008 Aug;103(8):1281-2
[PMID:
18855816
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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