nach oben

Journal of General Internal Medicine

Erschienen in:

09.02.2016 | Original Research

Alcohol Screening and Intervention Among United States Adults who Attend Ambulatory Healthcare

verfasst von: Joseph E. Glass, PhD, MSW, Kipling M. Bohnert, PhD, Richard L. Brown, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 7/2016

Einloggen, um Zugang zu erhalten

ABSTRACT

BACKGROUND

There is limited data on the extent to which indicated alcohol interventions are delivered in U.S. ambulatory care settings.

OBJECTIVE

To assess the receipt of alcohol-related services, including assessment of use, advice to reduce drinking, and information about alcohol treatment, during ambulatory care visits.

DESIGN

Secondary data analysis of the 2013 National Survey on Drug Use and Health, a cross-sectional, nationally representative survey of civilians in the non-institutionalized U.S. general population (response rate 71.7 %).

PARTICIPANTS

Adult ambulatory care users in the public use data file who did not obtain emergency or inpatient services (n = 17,266).

MAIN MEASURES

Measurements included respondents’ alcohol consumption, heavy episodic drinking, alcohol use disorder, healthcare use, and receipt of alcohol-related interventions.

KEY RESULTS

Approximately 71.1 % of ambulatory care users received an alcohol assessment. Among past-month heavy episodic drinkers without an alcohol use disorder who reported receiving an alcohol assessment, 4.4 % were advised to cut back. Among individuals with alcohol abuse and alcohol dependence who reported receiving an alcohol assessment, 2.9 % and 7.0 %, respectively, were offered information about treatment.

CONCLUSIONS

Rates of alcohol screening and assessment were relatively high among adults who attended healthcare visits, but rates of intervention were low, even when individuals were assessed for use. Efforts are needed to expand delivery of interventions when patients are identified as positive for risky drinking, hazardous alcohol use, and alcohol use disorders during ambulatory care visits.

National Institute on Alcohol Abuse and Alcoholism. Rethinking Drinking: Alcohol and Your Health. Rockville, MD: National Institutes of Health; 2010.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4th Edition, Text Revised). Washington, DC: American Psychiatric Association; 2000.

Grant BF, Stinson FS, Dawson DA, et al. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2004;61(8):807–16. doi:10.1001/archpsyc.61.8.807.CrossRefPubMed

Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238–45. doi:10.1001/jama.291.10.1238291/10/1238.CrossRefPubMed

Center for Disease Control and Prevention. Alcohol and public health: Data, trends, and maps. http://www.cdc.gov/alcohol/quickstats/binge_drinking.htm. Published 2014. Accessed July 3, 2014.

Bouchery EE, Harwood HJ, Sacks JJ, Simon CJ, Brewer RD. Economic costs of excessive alcohol consumption in the U.S., 2006. Am J Prev Med. 2011;41(5):516–24. doi:10.1016/j.amepre.2011.06.045.CrossRefPubMed

U.S. Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: recommendation statement. Ann Intern Med. 2004;140(7):554–6.CrossRef

U.S. Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: recommendation statement. Am Fam Physician. 2014;89(12):Online.

Fleming MF, Mundt MP, French MT, Manwell LB, Stauffacher EA, Barry KL. Benefit-cost analysis of brief physician advice with problem drinkers in primary care settings. Med Care. 2000;38(1):7–18.CrossRefPubMed

10.

Moyer A, Finney JW, Swearingen CE, Vergun P. Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction. 2002;97(3):279–92.CrossRefPubMed

11.

Babor TF, McRee BG, Kassebaum PA, Grimaldi PL, Ahmed K, Bray J. Screening, Brief Intervention, and Referral to Treatment (SBIRT): toward a public health approach to the management of substance abuse. Subst Abus. 2007;28(3):7–30.CrossRefPubMed

12.

National Institute on Alcohol Abuse and Alcoholism. Treatment for Alcohol Problems: Finding and Getting Help. Department of Health and Human Services; 2014.

13.

Edlund MJ, Unutzer J, Wells KB. Clinician screening and treatment of alcohol, drug, and mental problems in primary care: results from healthcare for communities. Med Care. 2004;42(12):1158–66.CrossRefPubMed

14.

McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348(26):2635–45. doi:10.1056/NEJMsa022615.CrossRefPubMed

15.

McGlynn EA, Asch SM, Adams J, et al. The Quality of Health Care Delivered to Adults in the United States (Appendix).; 2006.

16.

McKnight-Eily LR, Liu Y, Brewer RD, et al. Vital signs: communication between health professionals and their patients about alcohol use--44 states and the District of Columbia, 2011. MMWR Morb Mortal Wkly Rep. 2014;63(1):16–22.PubMed

17.

Arndt S, Schultz S, Turvey C, Petersen A. Screening for alcoholism in the primary care setting: are we talking to the right people? J Fam Pract. 2002;51(1):41–6.PubMed

18.

Centers for Medicare and Medicaid Services. Decision Memo for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse.; 2011. http://www.cms.gov/medicare-coverage-database/details/nca-decision- memo.aspx?NCAId = 249.

19.

Department of Health and Human Services Centers for Medicare & Medicaid Services. Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse.; 2011. http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM7633.pdf.

20.

Center for Behavioral Health Statistics and Quality. National Survey on Drug Use and Health (NSDUH): Summary of Methodological Studies, 1971–2014. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014.

21.

Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health (NSDUH): Summary of National Findings. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014.

22.

Lapham GT, Rubinsky AD, Shortreed SM, et al. Comparison of Provider-documented and Patient-reported Brief Intervention for Unhealthy Alcohol Use in VA outpatients. Drug Alcohol Depend. 2015. doi:10.1016/j.drugalcdep.2015.05.027.

23.

Courtney KE, Polich J. Binge drinking in young adults: Data, definitions, and determinants. Psychol Bull. 2009;135(1):142–56. doi:10.1037/a0014414.CrossRefPubMedPubMedCentral

24.

National Institute on Alcohol Abuse and Alcoholism. Helping Patients Who Drink Too Much: A Clinician’s Guide. Bethesda, MD; 2005.

25.

Kessler RC, Barker PR, Colpe LJ, et al. Screening for Serious Mental Illness in the General Population. Arch Gen Psychiatry. 2003;60(2):184. doi:10.1001/archpsyc.60.2.184.CrossRefPubMed

26.

StataCorp. Stata Statistical Software: Release 13. College Station, TX: StataCorp, LP; 2013.

27.

Bradley KA, Williams EC, Achtmeyer CE, Volpp B, Collins BJ, Kivlahan DR. Implementation of evidence-based alcohol screening in the Veterans Health Administration. Am J Manag Care. 2006;12(10):597–606.PubMed

28.

Lapham GT, Achtmeyer CE, Williams EC, Hawkins EJ, Kivlahan DR, Bradley KA. Increased documented brief alcohol interventions with a performance measure and electronic decision support. Med Care. 2012;50(2):179–87. doi:10.1097/MLR.0b013e3181e35743.CrossRefPubMed

29.

Brown RL, Moberg PD, Allen JB, et al. A team approach to systematic behavioral screening and intervention. Am J Manag Care. 2014;20(4):e113–21.PubMedPubMedCentral

30.

Saitz R. Alcohol screening and brief intervention in primary care: Absence of evidence for efficacy in people with dependence or very heavy drinking. Drug Alcohol Rev. 2010;29(6):631–40. doi:10.1111/j.1465-3362.2010.00217.x.CrossRefPubMedPubMedCentral

31.

Glass JE, Hamilton AM, Powell BJ, Perron BE, Brown RT, Ilgen MA. Specialty substance use disorder services following brief alcohol intervention: a meta-analysis of randomized controlled trials. Addiction. 2015;110(9):1404–15. doi:10.1111/add.12950.CrossRefPubMed

32.

Saitz R. “SBIRT” is the answer? Probably not. Addiction. 2015;110(9):1416–17. doi:10.1111/add.12986.CrossRefPubMed

33.

Cucciare M, Timko C. Bridging the gap between medical settings and specialty addiction treatment. Addiction. 2015;110(9):1417–1419. doi:10.1111/add.12977.CrossRefPubMed

34.

Glass JE. Challenges ahead in developing and testing referral to treatment interventions. Addiction. 2015;110(9):1419–20. doi:10.1111/add.13039.CrossRefPubMed

35.

Jonas DE, Amick HR, Feltner C, et al. Pharmacotherapy for adults with alcohol use disorders in outpatient settings: a systematic review and meta-analysis. JAMA. 2014;311(18):1889–1900. doi:10.1001/jama.2014.3628.CrossRefPubMed

36.

Oslin DW, Lynch KG, Maisto SA, et al. A randomized clinical trial of alcohol care management delivered in Department of Veterans Affairs primary care clinics versus specialty addiction treatment. J Gen Intern Med. 2014;29(1):162–8. doi:10.1007/s11606-013-2625-8.CrossRefPubMed

37.

Willenbring ML, Olson DH. A randomized trial of integrated outpatient treatment for medically ill alcoholic men. Arch Intern Med. 1999;159(16):1946–1952.CrossRefPubMed

38.

Saitz R, Cheng DM, Winter M, et al. Chronic Care Management for Dependence on Alcohol and Other Drugs: The AHEAD Randomized Trial. JAMA. 2013;310(11):1156. doi:10.1001/jama.2013.277609.CrossRefPubMedPubMedCentral

39.

Glass JE, Perron BE, Ilgen MA, Chermack ST, Ratliff S, Zivin K. Prevalence and correlates of specialty substance use disorder treatment for Department of Veterans Affairs Healthcare System patients with high alcohol consumption. Drug Alcohol Depend. 2010;112(1–2):150–5. doi:10.1016/j.drugalcdep.2010.06.003.CrossRefPubMedPubMedCentral

40.

Dobscha SK, Dickinson KC, Lasarev MR, Lee ES. Associations between race and ethnicity and receipt of advice about alcohol use in the Department of Veterans Affairs. Psychiatr Serv. 2009;60(5):663–70. doi:10.1176/appi.ps.60.5.663.CrossRefPubMed

41.

Ilgen MA, Price AM, Burnett-Zeigler I, et al. Longitudinal predictors of addictions treatment utilization in treatment-naïve adults with alcohol use disorders. Drug Alcohol Depend. 2011;113(2–3):215–21. doi:10.1016/j.drugalcdep.2010.08.006.CrossRefPubMed

42.

Wooten NR, Mohr BA, Lundgren LM, et al. Gender differences in substance use treatment utilization in the year prior to deployment in Army service members. J Subst Abuse Treat. 2013;45(3):257–65. doi:10.1016/j.jsat.2013.04.001.CrossRefPubMedPubMedCentral

43.

Glass JE, Kristjansson SD, Bucholz KK. Perceived alcohol stigma: factor structure and construct validation. Alcohol Clin Exp Res. 2013;37(Suppl 1):E237–46. doi:10.1111/j.1530-0277.2012.01887.x.CrossRefPubMed

44.

Fortney J, Mukherjee S, Curran G, Fortney S, Han X, Booth BM. Factors associated with perceived stigma for alcohol use and treatment among at-risk drinkers. J Behav Health Serv Res. 2004;31(4):418–29. doi:10.1097/00075484-200410000-00006.CrossRefPubMed

45.

Glass JE, Mowbray OP, Link BG, Kristjansson SD, Bucholz KK. Alcohol stigma and persistence of alcohol and other psychiatric disorders: A modified labeling theory approach. Drug Alcohol Depend. 2013;133(2):685–92. doi:10.1016/j.drugalcdep.2013.08.016.CrossRefPubMedPubMedCentral

46.

Wirth JH, Bodenhausen GV. The role of gender in mental-illness stigma: a national experiment. Psychol Sci. 2009;20(2):169–73. doi:10.1111/j.1467-9280.2009.02282.x.CrossRefPubMed

47.

Vinson DC, Turner BJ. Msed, Manning BK, Galliher JM. Clinician Suspicion of an Alcohol Problem: An Observational Study From the AAFP National Research Network. Ann Fam Med. 2013;11(1):53–9. doi:10.1370/afm.1464.CrossRefPubMedPubMedCentral

48.

Glass JE, Bucholz KK. Concordance between self-reports and archival records of physician visits: a case–control study comparing individuals with and without alcohol use disorders in the community. Drug Alcohol Depend. 2011;116(1–3):57–63. doi:10.1016/j.drugalcdep.2010.11.021.CrossRefPubMedPubMedCentral

49.

Killeen TK, Brady KT, Gold PB, Tyson C, Simpson KN. Comparison of self-report versus agency records of service utilization in a community sample of individuals with alcohol use disorders. Drug Alcohol Depend. 2004;73(2):141–7.CrossRefPubMed

50.

National Institute on Alcohol Abuse and Alcoholism. A Pocket Guide for Alcohol Screening and Brief Intervention. Bethesda, MD; 2005.

51.

Brown RL, Smith MA. Population-Level Quality Measures for Behavioral Screening and Intervention. Am J Med Qual. 2015. doi:10.1177/1062860615577131.

Titel: Alcohol Screening and Intervention Among United States Adults who Attend Ambulatory Healthcare
verfasst von: Joseph E. Glass, PhD, MSW
Kipling M. Bohnert, PhD
Richard L. Brown, MD, MPH
Publikationsdatum: 09.02.2016
Verlag: Springer US
Erschienen in: Journal of General Internal Medicine / Ausgabe 7/2016
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-016-3614-5

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Echinokokkose medikamentös behandeln oder operieren?

06.05.2024 DCK 2024 Kongressbericht

Die Therapie von Echinokokkosen sollte immer in spezialisierten Zentren erfolgen. Eine symptomlose Echinokokkose kann – egal ob von Hunde- oder Fuchsbandwurm ausgelöst – konservativ erfolgen. Wenn eine Op. nötig ist, kann es sinnvoll sein, vorher Zysten zu leeren und zu desinfizieren.

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

ABSTRACT

BACKGROUND

OBJECTIVE

DESIGN

PARTICIPANTS

MAIN MEASURES

KEY RESULTS

CONCLUSIONS

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2016

Getting from Intention to Action

Pneumocystis Jirovecii Presenting as Nodular Pulmonary Opacities

Evidence-Based Care for People with Unhealthy Alcohol Use—Still Elusive

Diffuse Alveolar Hemorrhage: Blood, Sweat and Tears

Communication Skills Training for Physicians Improves Patient Satisfaction

Cost of Transformation among Primary Care Practices Participating in a Medical Home Pilot