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Published in: Journal of General Internal Medicine 9/2008

01-09-2008 | Brief Report

Alcohol Counseling Reflects Higher Quality of Primary Care

Authors: Richard Saitz, MD, MPH, Nicholas J. Horton, ScD, Debbie M. Cheng, ScD, Jeffrey H. Samet, MD, MA, MPH

Published in: Journal of General Internal Medicine | Issue 9/2008

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Abstract

Background

Some primary care physicians do not conduct alcohol screening because they assume their patients do not want to discuss alcohol use.

Objectives

To assess whether (1) alcohol counseling can improve patient-perceived quality of primary care, and (2) higher quality of primary care is associated with subsequent decreased alcohol consumption.

Design

A prospective cohort study.

Subjects

Two hundred eighty-eight patients in an academic primary care practice who had unhealthy alcohol use.

Measurements

The primary outcome was quality of care received [measured with the communication, whole-person knowledge, and trust scales of the Primary Care Assessment Survey (PCAS)]. The secondary outcome was drinking risky amounts in the past 30 days (measured with the Timeline Followback method).

Results

Alcohol counseling was significantly associated with higher quality of primary care in the areas of communication (adjusted mean PCAS scale scores: 85 vs. 76) and whole-person knowledge (67 vs. 59). The quality of primary care was not associated with drinking risky amounts 6 months later.

Conclusions

Although quality of primary care may not necessarily affect drinking, brief counseling for unhealthy alcohol use may enhance the quality of primary care.
Literature
2.
go back to reference US Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: recommendation statement. Ann Intern Med. 2004;140(7):554–6. US Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: recommendation statement. Ann Intern Med. 2004;140(7):554–6.
3.
go back to reference Aalto M, Seppa K. Usefulness, length and content of alcohol-related discussions in primary health care: the exit poll survey. Alcohol Alcohol. 2004;39(6):532–5.PubMed Aalto M, Seppa K. Usefulness, length and content of alcohol-related discussions in primary health care: the exit poll survey. Alcohol Alcohol. 2004;39(6):532–5.PubMed
4.
go back to reference Bradley KA, Curry SJ, Koepsell TD, Larson EB. Primary and secondary prevention of alcohol problems: US internist attitudes and practices. J Gen Intern Med. 1995;10(2):67–72.PubMedCrossRef Bradley KA, Curry SJ, Koepsell TD, Larson EB. Primary and secondary prevention of alcohol problems: US internist attitudes and practices. J Gen Intern Med. 1995;10(2):67–72.PubMedCrossRef
5.
go back to reference Saitz R, Horton NJ, Sullivan LM, Moskowitz MA, Samet JH. Addressing alcohol problems in primary care: a cluster randomized, controlled trial of a systems intervention. The screening and intervention in primary care (SIP) study. Ann Intern Med. 2003;138(5):372–82.PubMed Saitz R, Horton NJ, Sullivan LM, Moskowitz MA, Samet JH. Addressing alcohol problems in primary care: a cluster randomized, controlled trial of a systems intervention. The screening and intervention in primary care (SIP) study. Ann Intern Med. 2003;138(5):372–82.PubMed
6.
go back to reference McGlynn E, Asch S, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348(26):2635–45.PubMedCrossRef McGlynn E, Asch S, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med. 2003;348(26):2635–45.PubMedCrossRef
7.
go back to reference Friedmann PD, McCullough D, Chin MH, Saitz R. Screening and intervention for alcohol problems: a national survey of primary care physicians and psychiatrists. J Gen Intern Med. 2000;15(2):84–91.PubMedCrossRef Friedmann PD, McCullough D, Chin MH, Saitz R. Screening and intervention for alcohol problems: a national survey of primary care physicians and psychiatrists. J Gen Intern Med. 2000;15(2):84–91.PubMedCrossRef
8.
go back to reference Beich A, Gannik D, Malterud K. Screening and brief intervention for excessive alcohol use: qualitative interview study of the experiences of general practitioners. BMJ. 2002;325(7369):870–4.PubMedCrossRef Beich A, Gannik D, Malterud K. Screening and brief intervention for excessive alcohol use: qualitative interview study of the experiences of general practitioners. BMJ. 2002;325(7369):870–4.PubMedCrossRef
9.
go back to reference Safran DG, Taira DA, Rogers WH, Kosinski M, Ware JE, Tarlov AR. Linking primary care performance to outcomes of care. J Fam Pract. 1998;47(3):213–20.PubMed Safran DG, Taira DA, Rogers WH, Kosinski M, Ware JE, Tarlov AR. Linking primary care performance to outcomes of care. J Fam Pract. 1998;47(3):213–20.PubMed
10.
go back to reference Aalto M, Pekuri P, Seppa K. Primary health care professionals’ activity in intervening in patients’ alcohol drinking: a patient perspective. Drug Alcohol Depend. 2002;66(1):39–43.PubMedCrossRef Aalto M, Pekuri P, Seppa K. Primary health care professionals’ activity in intervening in patients’ alcohol drinking: a patient perspective. Drug Alcohol Depend. 2002;66(1):39–43.PubMedCrossRef
11.
go back to reference Zimmerman M, Farber NJ, Hartung J, Lush DT, Kuzma MA. Screening for psychiatric disorders in medical patients: a feasibility and patient acceptance study. Med Care. 1994;32(6):603–8.PubMedCrossRef Zimmerman M, Farber NJ, Hartung J, Lush DT, Kuzma MA. Screening for psychiatric disorders in medical patients: a feasibility and patient acceptance study. Med Care. 1994;32(6):603–8.PubMedCrossRef
12.
go back to reference Steven ID, Thomas SA, Eckerman E, Browning C, Dickens E. The provision of preventive care by general practitioners measured by patient completed questionnaires. J Qual Clin Pract. 1999;19(4):195–201.PubMedCrossRef Steven ID, Thomas SA, Eckerman E, Browning C, Dickens E. The provision of preventive care by general practitioners measured by patient completed questionnaires. J Qual Clin Pract. 1999;19(4):195–201.PubMedCrossRef
13.
go back to reference Mayfield D, McLeod G, Hall P. The CAGE questionnaire: validation of a new alcoholism screening instrument. Am J Psychiatry. 1974;131(10):1121–3.PubMed Mayfield D, McLeod G, Hall P. The CAGE questionnaire: validation of a new alcoholism screening instrument. Am J Psychiatry. 1974;131(10):1121–3.PubMed
14.
go back to reference Saunders JB, Lee NK. Hazardous alcohol use: its delineation as a subthreshold disorder, and approaches to its diagnosis and management. Compr Psychiatry. 2000;41(2 Suppl 1):95–103.PubMedCrossRef Saunders JB, Lee NK. Hazardous alcohol use: its delineation as a subthreshold disorder, and approaches to its diagnosis and management. Compr Psychiatry. 2000;41(2 Suppl 1):95–103.PubMedCrossRef
15.
go back to reference Rollnick S, Heather N, Gold , Hall W. Development of a short ‘readiness to change’ questionnaire for use in brief, opportunistic interventions among excessive drinkers. Br J Addict. 1992;87(5):743–54.PubMedCrossRef Rollnick S, Heather N, Gold , Hall W. Development of a short ‘readiness to change’ questionnaire for use in brief, opportunistic interventions among excessive drinkers. Br J Addict. 1992;87(5):743–54.PubMedCrossRef
16.
go back to reference Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW. Can comorbidity be measured by questionnaire rather than medical record review? Med Care. 1996;34(1):73–84.PubMedCrossRef Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW. Can comorbidity be measured by questionnaire rather than medical record review? Med Care. 1996;34(1):73–84.PubMedCrossRef
17.
go back to reference Safran DG, Kosinski M, Tarlov A, et al. The Primary Care Assessment Survey: tests of data quality and measurement performance. Med Care. 1998;36(5):728–39.PubMedCrossRef Safran DG, Kosinski M, Tarlov A, et al. The Primary Care Assessment Survey: tests of data quality and measurement performance. Med Care. 1998;36(5):728–39.PubMedCrossRef
18.
go back to reference Institute of Medicine. Primary care: America's health in a new era. Washington, D.C.: National Academy Press; 1996. Institute of Medicine. Primary care: America's health in a new era. Washington, D.C.: National Academy Press; 1996.
19.
go back to reference Sobell LC, Brown J, Leo GI, Sobell MB. The reliability of the Alcohol Timeline Followback when administered by telephone and by computer. Drug Alcohol Depend. 1996;42(1):49–54.PubMedCrossRef Sobell LC, Brown J, Leo GI, Sobell MB. The reliability of the Alcohol Timeline Followback when administered by telephone and by computer. Drug Alcohol Depend. 1996;42(1):49–54.PubMedCrossRef
20.
go back to reference Miller W, Tonigan J, Longabaugh R. The Drinker Inventory of Consequences (DrInC). An Instrument for Assessing Adverse Consequences of Alcohol Abuse. Test Manual. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism; 1995. Miller W, Tonigan J, Longabaugh R. The Drinker Inventory of Consequences (DrInC). An Instrument for Assessing Adverse Consequences of Alcohol Abuse. Test Manual. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism; 1995.
21.
go back to reference Kim TW, Samet JH, Cheng DM, Winter M, Safran DG, Saitz R. Primary care quality and addiction severity: a prospective cohort study. Health Serv Res. 2007;42(2):755–72.PubMedCrossRef Kim TW, Samet JH, Cheng DM, Winter M, Safran DG, Saitz R. Primary care quality and addiction severity: a prospective cohort study. Health Serv Res. 2007;42(2):755–72.PubMedCrossRef
Metadata
Title
Alcohol Counseling Reflects Higher Quality of Primary Care
Authors
Richard Saitz, MD, MPH
Nicholas J. Horton, ScD
Debbie M. Cheng, ScD
Jeffrey H. Samet, MD, MA, MPH
Publication date
01-09-2008
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 9/2008
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-008-0574-4

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