Alcohol-related discussions in primary care: A report from ASPN

Daniel C. Vinson, Nancy Elder, James J. Werner, Laurie A. Vorel, Paul A. Nutting

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

BACKGROUND - Problem drinking is common, and a 15-minute intervention can help some patients reduce drinking to safe levels. Little is known, however, about the frequency and duration of alcohol-related discussions in primary care. METHODS - Nineteen clinicians in the Ambulatory Sentinel Practice Network (ASPN) collected data about alcohol-related discussions for 1 week following their usual office routine (Phase 1) and for 1 week with the addition of routine screening for problem drinking (Phase 2). Of those, 15 clinicians collected data for a third week after receiving training in brief interventions with problem drinkers (Phase 3). Clinicians collected data on standard ASPN reporting cards. RESULTS - In Phase 1 the clinicians discussed alcohol during 9.6% of all visits. Seventy-three percent of those discussions were shorter than 2 minutes long, and only 10% lasted longer than 4 minutes. When routine screening was added (Phase 2), clinicians were more likely to discuss alcohol at acute-illness visits, but the frequency, duration, and intensity of such discussions did not change. Only 32% of Phase 2 discussions prompted by a positive screening result lasted longer than 2 minutes. After training, the duration increased (P <.004). In Phase 3, 58% of discussions prompted by a positive screening result lasted longer than 2 minutes, but only 26% lasted longer than 4 minutes. CONCLUSIONS - Routine screening changed the kinds of visits during which clinicians discussed alcohol use. Training in brief-intervention techniques significantly increased the duration of alcohol-related discussions, but most discussions prompted by a positive screening result were still shorter than effective interventions reported in the literature.

Original languageEnglish (US)
Pages (from-to)28-33
Number of pages6
JournalJournal of Family Practice
Volume49
Issue number1
StatePublished - Jan 2000

Keywords

  • Alcohol drinking
  • Alcoholism
  • Physician-patient relations
  • Substance abuse detection

ASJC Scopus subject areas

  • Family Practice

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