Recognizing Unhealthy Alcohol Use in Primary Care Setting

[liveonearth]

And the question is:
How many times in the past year have you had X or more drinks in a day?
--X = 4 for women and 5 for men
--a positive result is an answer of one or more times in the last year
--unhealthy alcohol defined as consumption of risky amounts of alcohol OR a current alcohol use disorder
--risky?? define that.

Text from medscape:

"Unhealthy alcohol use is prevalent but under-diagnosed in primary care settings," write Peter C. Smith, MD, MSc, from Boston University School of Medicine in Boston, Massachusetts, and colleagues. "Screening and brief intervention by primary care physicians for those with unhealthy alcohol use reduces risky consumption. Because of this, practice guidelines recommend universal screening."

The goal of this study was to validate a single-item screening test for unhealthy alcohol use recommended by the NIAAA.

Adult English-speaking patients recruited from primary care waiting rooms were asked, "How many times in the past year have you had X or more drinks in a day?" (X = 5 for men and 4 for women). A positive response to this single-question screen was defined as more than 1. Patients were considered to have unhealthy alcohol use if a standardized diagnostic interview revealed the presence of an alcohol use disorder or if a validated 30-day calendar method showed risky consumption.

The interview was completed by 286 (73%) of 394 eligible primary care patients. For identification of unhealthy alcohol use, the single-question screen was 81.8% sensitive (95% confidence interval [CI], 72.5% - 88.5%) and 79.3% specific (95% CI, 73.1% - 84.4%). For identification of a current alcohol use disorder, the single-question screen was slightly more sensitive (87.9%; 95% CI, 72.7% - 95.2%) but was less specific (66.8%; 95% CI, 60.8% - 72.3%).

..."The sensitivity and specificity of this single question was comparable to that reported for longer instruments in other studies," the study authors conclude.

SOURCE:
http://www.medscape.com/viewarticle/589706?src=mpnews&spon=34&uac=89474MT

Comments

[hausfrauatu.livejournal.com]

Mmmmmmm.

My aunt went into the hospital for liver problems. I'm sure she lied about her alcohol abuse. I have a feeling that the liver enzyme test was a big tip off. My friend's husband (surgeon) says people lie all the time about everything. It's frustrating.

[liveonearth.livejournal.com]

It seems t's really a trick to find out what is going on with a sick person when they won't tell you what they do every day. So we have to come up with sneaky questions to ask that are relevant but don't trigger the "I have to lie" reaction.

Yep, the liver enzymes tell the story that patients don't want known about their alcohol abuse.