Journal Article

Alcohol-related discussions during general medicine appointments of male VA patients who screen positive for at-risk drinking

Epler, Amee J., Cochran, Nancy E., Braddock, Clarence H., Fihn, Stephan D., Bradley, Katharine A., Dunn, Christopher W., Bush, Kristen R., Sporleder, Jennifer L., McDonell, Mary B.

2002

Overview

This study describes primary care discussions with patients who screened positive for at-risk drinking. In addition, discussions about alcohol use from 2 clinic firms, one with a provider-prompting intervention, are compared. Cross-sectional analyses of audiotaped appointments collected over 6 months. Male patients in a VA general medicine clinic were eligible if they screened positive for at-risk drinking and had a general medicine appointment with a consenting provider during the study period. Participating patients ( N = 47) and providers ( N = 17) were enrolled in 1 of 2 firms in the clinic (Intervention or Control) and were blinded to the study focus. Intervention providers received patient-specific results of positive alcohol-screening tests at each visit. Of 68 visits taped, 39 (57.4%) included any mention of alcohol. Patient and provider utterances during discussions about alcohol use were coded using Motivational Interviewing Skills Codes. Providers contributed 58% of utterances during alcohol-related discussions with most coded as questions (24%), information giving (23%), or facilitation (34%). Advice, reflective listening, and supportive or affirming statements occurred infrequently (5%, 3%, and 5%, of provider utterances respectively). Providers offered alcohol-related advice during 21% of visits. Sixteen percent of patient utterances reflected \"resistance\" to change and 12% reflected readiness to change. On average, Intervention providers were more likely to discuss alcohol use than Control providers (82.4% vs 39.6% of visits; P =.026). During discussions about alcohol, general medicine providers asked questions and offered information, but usually did not give explicit alcohol-related advice. Discussions about alcohol occurred more often when providers were prompted.

• Publisher: Springer,Springer Nature B.V
• Subject: Addictive behaviors / Adult and adolescent clinical studies / Alcohol Drinking - psychology / Alcohol use / Alcoholism / Alcoholism - diagnosis / Ambulatory care / Ambulatory Care Facilities / Biological and medical sciences / Cardiovascular disease / Clinical trials / Female / Health care / Health services / Humans / Internal medicine / Intervention / Male / Medical sciences / Medicine / Middle Aged / Motivation / Patient Education as Topic / Patients / Primary care / Primary Health Care / Psychology. Psychoanalysis. Psychiatry / Psychopathology. Psychiatry / Questionnaires / R&D / Research & development / Substance Abuse Detection - psychology / Tape Recording / Veterans