Top

Published in:

01-12-2010 | Original Article

Severity of unhealthy alcohol consumption in medical inpatients and the general population: is the general hospital a suitable place for brief interventions?

Authors: Gallus Bischof, Susa Reinhardt, Jennis Freyer-Adam, Beate Coder, Janina M. Grothues, Christian Meyer, Ulrich John, Hans-Jürgen Rumpf

Published in: International Journal of Public Health | Issue 6/2010

Abstract

Objectives

Evidence for brief interventions in general hospital (GH) settings is scarce, probably due to higher rates of dependent drinkers. The present study aims to compare unhealthy drinking patterns in GH patients with the general population (GP).

Methods

Sample 1 consisted of 4,075 individuals randomly drawn from registration office files, representing the non-institutionalised GP of a northern mixed rural–urban German area. Sample 2 consisted of 2,949 consecutively admitted patients from a GH covering the same area.

Results

Compared to individuals from the GP, GH patients revealed higher prevalence rates of alcohol dependence (1.3 vs. 5.5%) and alcohol abuse (1.2 vs. 2.8%), but did not differ significantly concerning at-risk drinking (5.1 vs. 6.2%). Multinomial logistic regression analysis controlling for age, sex and smoking using unrisky alcohol consumption as reference category belonging to the GH group was predictive for alcohol use disorders but not for at-risk drinking.

Conclusion

Data show that a substantial number of individuals with unhealthy drinking patterns without alcohol use disorders can easily be accessed in GH settings if appropriate screening measures are conducted.

American Psychiatric Association (ed) (1995) Diagnostic and statistical manual of mental disorders, international version, 4th edn. American Psychiatric Association, Washington, DC

Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG (2001) The alcohol use disorders identification test. Guidelines for use in primary care. 2nd edn. World Health Organization, Geneva

Bertholet N, Daeppen JB, Wietslisbach V, Fleming M, Burnand B (2005) Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med 165:986–995CrossRefPubMed

Bischof G, Rumpf HJ, Meyer C, Hapke U, John U (2004) Inanspruchnahme medizinischer Versorgung bei Rauchern und riskant Alkohol konsumierenden Personen: Ergebnisse einer repräsentativen Bevölkerungsstudie [Medical care requested by smokers and at-risk alcohol consumers: results of a representative population survey]. Gesundheitswesen 66:114–120CrossRefPubMed

Bischof G, Reinhardt S, Grothues J, Meyer C, John U, Rumpf HJ (2007) Development and evaluation of a screening instrument for alcohol use disorders and at-risk drinking: the brief alcohol screening instrument for medical care BASIC. J Stud Alcohol Drugs 68:607–614PubMed

British Medical Association (1995) Guidelines on sensible drinking. British Medical Association, London

Chen CH, Chen WJ, Cheng AT (2004) Prevalence and identification of alcohol use disorders among nonpsychiatric inpatients in one general hospital. Gen Hosp Psychiatry 26:219–225CrossRefPubMed

DeNavas-Walt C, Proctor BD, Lee CH (2006) Income, poverty, and health insurance coverage in the United States: 2005. US Goverment Printing Office, Washington, DC

Emmen MJ, Schippers GM, Bleijenberg G, Wollersheim H (2004) Effectiveness of opportunistic brief interventions for problem drinking in a general hospital setting: systematic review. BMJ 328:318CrossRefPubMed

Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ (2002) Selected major risk factors and global and regional burden of disease. Lancet 360(9343):1347–1360CrossRefPubMed

Freyer J, Coder B, Pockrandt C, Hartmann B, Rumpf HJ, John U, Hapke U (2006) Krankenhauspatienten mit riskantem Alkoholkonsum sind offen für Beratung. Gesundheitswesen 68(7):429–435CrossRefPubMed

Freyer J, Coder B, Bischof G, Baumeister SE, Rumpf HJ, John U, Hapke U (2007) Intention to utilize formal help in a sample with alcohol problems: a prospective study. Drug Alcohol Depend 37:210–216CrossRef

Grant BF (1997) Prevalence and correlates of alcohol use and DSM-IV alcohol dependence in the United States: results of the National Longitudinal Alcohol Epidemiologic Survey. J Stud Alcohol 58:464–473PubMed

Grant BF, Dawson DA, Stinson FS, Chou SP, Dufour MC, Pickering RP (2004) The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002. Drug Alcohol Depend 74(3):223–234CrossRefPubMed

Holloway AS, Watson HE, Arthut AJ, Starr G, McFayden AK, McIntosh J (2007) The effect of brief interventions on alcohol consumption among heavy drinkers in a general hospital setting. Addiction 102:1762–1770CrossRefPubMed

John U, Rumpf HJ, Hapke U (1999) Estimating prevalence of alcohol abuse and dependence in one general hospital—an approach to reduce sample selection bias. Alcohol Alcohol 34:786–794PubMed

Kraus L, Augustin R, Röder J (2006) Ergebnisse der Epidemiologischen Suchtsurveys von 1980 bis 2003 [Results of the epidemiological survey of substance abuse from 1980 to 2003]. Jahrbuch Sucht. DHS. Geesthacht, Neuland

Meyer C, Rumpf HJ, Hapke U, John U (1998) Regionale Unterschiede in der Prävalenz riskanten Alkoholkonsums: Sekundäranalyse des Gesundheitssurvey Ost-West [Regional differences in the prevalence of hazardous alcohol consumption: a reanalyis of the “Health Survey EAST and West Germany”]. Gesundheitswesen 60:486–492PubMed

Meyer C, Rumpf HJ, Hapke U, Dilling H, John U (2000) Prevalence of alcohol consumption, abuse and dependence in a country with high per capita consumption: findings from the German TACOS study. Soc Psychiatry Psychiatr Epidemiol 35:539–547CrossRefPubMed

Meyer C, Rumpf HJ, Hapke U, John U (2001) Prevalence of DSM-IV psychiatric disorders including nicotine dependence in the general population: results from the northern Germany TACOS study. Neurol Psych Brain Res 9:75–80

Moyer A, Finney JW, Swearingen CE, Vergun P (2002) Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction 97:279–292CrossRefPubMed

Poikolainen K (1999) Effectiveness of brief interventions to reduce alcohol intake in primary health care populations: a meta-analysis. Prev Med 28:503–509CrossRefPubMed

Reinert DF, Allen JP (2007) The alcohol use disorders identification test: an update of research findings. Alcohol Clin Exp Res 31(2):185–199CrossRefPubMed

Robins LN, Wing J, Wittchen HU (1988) The composite international diagnostic interview: an epidemiological instrument suitable for use in conjunction with different diagnostic systems and in different cultures. Arch Gen Psychiatry 45:1069–1077PubMed

Roche AM, Freeman T, Skinner N (2006) From data to evidence, to action: findings from a systematic review of hospital screening studies for high risk alcohol consumption. Drug Alcohol Depend 83:1–14CrossRefPubMed

Rumpf HJ, Hapke U, Hill A, John U (1997) Development of a screening questionnaire for the general hospital and general practices. Alcohol Clin Exp Res 21:894–898PubMed

Rumpf HJ, Hapke U, Meyer C, John U (1999) Motivation to change drinking behavior: comparison of alcohol dependent individuals in a general hospital and a general population sample. Gen Hosp Psychiatry 21:348–353CrossRefPubMed

Saitz R, Freedner N, Palfai TP, Horton NJ, Samet JH (2006) “The severity of unhealthy alcohol use in hospitalized medical patients. The spectrum is narrow”. J Gen Intern Med 21:381–385CrossRefPubMed

Saitz R, Palfai TP, Cheng DM, Horton NJ, Freedner N, Dukes K, Kraemer KL, Roberts MS, Guerriero RT, Samet JH (2007) Brief Intervention for medical inpatients with unhealthy alcohol use. A randomized, controlled trial. Ann Intern Med 146:167–176PubMed

Thyrian JR, John U (2007) Population impact–definition, calculation and its use in prevention science in the example of tobacco smoking reduction. Health Policy 82(3):348–356CrossRefPubMed

Velicer WF, Prochaska JO, Fava JL, Laforge RG, Rossi JS (1999) Interactive versus noninteractive interventions and dose-response relationships for stage-matched smoking cessation programs in a managed care setting. Health Psychol 1:21–28CrossRef

Vitale SG, Van De Mheen D, Van De Wiel A, Garretsen HF (2006) Alcohol and illicit drug use among emergency room patients in the Netherlands. Alcohol Alcohol 41:553–559PubMed

Wilk AI, Jensen NM, Havighurst TC (1997) Meta-analysis of randomized control trials addressing brief interventions in heavy alcohol drinkers. J Gen Intern Med 12:274–283CrossRefPubMed

Wittchen H-U, Beloch E, Garczynski E, Holly A, Lachner G, Perkonigg A, Vodermaier A, Vossen A, Wunderlich U, Zieglgänsberger S (1995) Münchener composite international diagnostic interview (M-CIDI), Version 2.2. Max-Planck-Institut für Psychiatrie, München

Wu SI, Liu SI, Fang CK, Hsu CC, Sun YW (2006) Prevalence and detection of alcohol use disorders among general hospital inpatients in eastern Taiwan. Gen Hosp Psychiatry 28:48–54CrossRefPubMed

Title: Severity of unhealthy alcohol consumption in medical inpatients and the general population: is the general hospital a suitable place for brief interventions?
Authors: Gallus Bischof
Susa Reinhardt
Jennis Freyer-Adam
Beate Coder
Janina M. Grothues
Christian Meyer
Ulrich John
Hans-Jürgen Rumpf
Publication date: 01-12-2010
Publisher: SP Birkhäuser Verlag Basel
Published in: International Journal of Public Health / Issue 6/2010
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-010-0122-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Severity of unhealthy alcohol consumption in medical inpatients and the general population: is the general hospital a suitable place for brief interventions?

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2010

Communication, social capital and workplace health management as determinants of the innovative climate in German banks

Using Directed Acyclic Graphs to detect limitations of traditional regression in longitudinal studies

Workplace smoking restrictions: smoking behavior and the intention to change among continuing smokers

Married men who have sex with men: the bridge to HIV prevention in Mumbai, India

From awareness to action on the social determinants of health

The potential contribution of small-scale intervention projects in the field to the national health information system for HIV and sexually transmitted infections: a case study of a multilevel intervention in Guatemala