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Release: Jan. 15, 2002

Study: Primary Care Physicians Need To Screen For Alcohol Problems

Physicians speak with patients less frequently about alcohol use than about other health-related behaviors, according to a study by researchers at the University of Iowa department of psychiatry.

This new finding, in a study published in the January issue of the Journal of Family Practice, is one of the first of its kind, said Stephan Arndt, Ph.D., professor in the UI department of psychiatry and lead author of the study. Arndt also is director of the Iowa Consortium for Substance Abuse Research and Evaluation, based at the UI Oakdale Research Campus. The study was funded in part by the consortium.

"The goal of this study was to look at how often primary care physicians screened for alcohol problems among their patients," Arndt said. "While studies have been done on primary care physicians screening for illegal drugs, not many studies have focused on alcohol use."

The data were based on telephone interviews conducted by the 1997 Behavioral Risk Factors Surveillance System (BRFSS), an annual surveying system of the U.S. Centers for Disease Control and Prevention that involved a random sample of people living within the United States. The study selected 23,349 adults, ages 18 and older, who reported having a routine physical examination within the past three years.

The survey looked to find out which patients were assessed for excessive alcohol use and what characteristics predicted the assessment, and how often did discussions about alcohol occur compared with other health risk discussions such as eating habits or smoking.

Arndt and his colleagues found that about one in six patients reported that a physician or other health care worker had initiated a discussion about alcohol use. Men, nonwhites, and uneducated, low income, unmarried and young patients were asked more frequently about alcohol use. Interestingly, whites reported a higher consumption of alcohol, as did higher income and educated patients. While divorced patients reported discussions about alcohol use frequently,

widowed patients reported them least often. Women, and especially widowed women, were rarely asked about their alcohol use. Researchers found that physicians tended to ask patients about AIDS, smoking and other health-related behaviors more than alcohol use.

More than one in nine people in the sample met criteria for excessive drinking (consuming 60 or more drinks per month or five or more drinks in a single occasion in the past month). Based on this definition, slightly more than one in four excessive drinkers reported a discussion about alcohol with a physician.

One reason physicians don't ask about alcohol use is that many physicians feel they are not trained to recognize and deal with alcohol problems, Arndt said.

He noted that the study findings are important in order to help prevent alcohol problems in the United States.

"Money is spent every year trying to clean up alcohol problems in this country," Arndt said. "Instead, this money should be spent on prevention. Just a few minutes of asking questions about someone's alcohol use can have a huge impact."

Referring an at-risk patient to a treatment center or drug rehabilitation counselor is effective in preventing significant alcohol problems, Arndt said.

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