NIH study finds doctors miss many alcohol screening opportunities
Physicians often fail to counsel their young adult patients about excessive alcohol use, according to a study led by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health.
NIAAA guidelines for low risk drinking call for men to drink no more than four drinks in a day and no more than 14 drinks per week. For women, the guidelines are three or fewer drinks per day and no more than seven drinks per week. Previous studies have shown that screening and brief interventions by health care providers – asking patients about alcohol use and advising them to reduce risky drinking -- can promote significant, lasting reductions in drinking levels and alcohol-related problems. In addition to NIAAA, professional groups such as the American Medical Association and the American Society of Addiction Medicine, as well as the U.S Preventive Services Task Force, recommend routine screening for alcohol misuse in primary care and brief interventions for individuals who screen positive.
In the current study, Ralph W. Hingson, Sc.D., director of NIAAA’s division of epidemiology and prevention research, and colleagues at Boston University School of Public Health and Boston Medical Center conducted a random survey of more than 4,000 people in the United States between the ages of 18 and 39. The researchers asked survey participants about their drinking habits and whether they had been seen by a doctor during the past year. Those who had seen a doctor were asked additional questions to determine whether the doctor had assessed their alcohol use and advised them about safe drinking practices during the visit. The researchers report that 16 percent of those surveyed were non-drinkers, 24 percent drank at or below daily or weekly limits, 47 percent exceeded daily or weekly limits, and 13 percent exceeded both. The findings are online in the Journal of General Internal Medicine.
“Two-thirds of the people we surveyed had been seen by a doctor in the past year,” says Dr. Hingson. “However, of individuals whose drinking exceeded NIAAA guidelines, only 49 percent recalled being asked about their drinking, and only 14 percent were counseled about it. Young adults between ages 18 and 25 were the most likely to report drinking in excess of NIAAA guidelines, and only 34 percent of them were asked about drinking by their doctors, compared with 54 percent of adults ages 26 to 39.”
“In the United States, excessive alcohol use is the third leading preventable cause of death,” says NIAAA Acting Director Kenneth Warren, Ph.D. “It’s also a significant cause of disability for men and women in this country. The findings reported by Dr. Hingson and his colleagues indicate that we must redouble our efforts to help clinicians make alcohol screening and brief intervention a routine part of patient care in the United States.”
Dr. Warren adds that NIAAA’s ‘Helping Patients Who Drink Too Much: A Clinician’s Guide, available at the NIAAA website, provides a research-based, simplified approach to alcohol screening and brief intervention for both primary care and mental health clinicians.
Reference
Young Adults at Risk for Excess Alcohol Consumption Are Often Not Asked or Counseled About Drinking Alcohol
Ralph W. Hingson, et al.
Journal of General Internal Medicine
(September 21, 2011)