Document Detail


Using alcohol screening results and treatment history to assess the severity of at-risk drinking in Veterans Affairs primary care patients.
MedLine Citation:
PMID:  15084903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Primary care providers need practical methods for managing patients who screen positive for at-risk drinking. We evaluated whether scores on brief alcohol screening questionnaires and patient reports of prior alcohol treatment reflect the severity of recent problems due to drinking. METHODS: Veterans Affairs general medicine outpatients who screened positive for at-risk drinking were mailed questionnaires that included the Alcohol Use Disorders Identification Test (AUDIT) and a question about prior alcohol treatment or participation in Alcoholics Anonymous ("previously treated"). AUDIT questions 4 through 10 were used to measure past-year problems due to drinking (PYPD). Cross-sectional analyses compared the prevalence of PYPD and mean Past-Year AUDIT Symptom Scores (0-28 points) among at-risk drinkers with varying scores on the CAGE (0-4) and AUDIT-C (0-12) and varying treatment histories. RESULTS: Of 7861 male at-risk drinkers who completed questionnaires, 33.9% reported PYPD. AUDIT-C scores were more strongly associated with Past-Year AUDIT Symptom Scores than the CAGE (p < 0.0005). The prevalence of PYPD increased from 33% to 46% over the range of positive CAGE scores but from 29% to 77% over the range of positive AUDIT-C scores. Among subgroups of at-risk drinkers with the same screening scores, patients who reported prior treatment were more likely than never-treated at-risk drinkers to report PYPD and had higher mean Past-Year AUDIT Symptom Scores (p < 0.0005). We propose a simple method of risk-stratifying patients using AUDIT-C scores and alcohol treatment histories. CONCLUSIONS: AUDIT-C scores combined with one question about prior alcohol treatment can help estimate the severity of PYPD among male Veterans Affairs outpatients.
Authors:
Katharine A Bradley; Daniel R Kivlahan; Xiao-Hua Zhou; Jennifer L Sporleder; Amee J Epler; Kinsey A McCormick; Joseph O Merrill; Mary B McDonell; Stephan D Fihn
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Alcoholism, clinical and experimental research     Volume:  28     ISSN:  0145-6008     ISO Abbreviation:  Alcohol. Clin. Exp. Res.     Publication Date:  2004 Mar 
Date Detail:
Created Date:  2004-04-15     Completed Date:  2004-05-10     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7707242     Medline TA:  Alcohol Clin Exp Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  448-55     Citation Subset:  IM    
Affiliation:
Northwest Health Services Research and Development Center of Excellence, Primary and Specialty Medical Care Service,VA Puget Sound Health Care System, Seattle, WA 98108, USA. willi@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Alcohol Drinking / epidemiology,  therapy
Alcoholism / diagnosis*,  epidemiology,  therapy*
Ambulatory Care* / methods,  statistics & numerical data
Humans
Male
Middle Aged
Primary Health Care* / methods,  statistics & numerical data
Questionnaires
Risk Factors
Treatment Outcome
Veterans / statistics & numerical data*
Grant Support
ID/Acronym/Agency:
K23AA00313/AA/NIAAA NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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