Implementation of CAGE alcohol screening in a primary care practice.
OBJECTIVE
Alcoholism is a common problem in primary care. Although the four-question CAGE screening tool was developed for use by primary care physicians, studies show that the questionnaire is still not widely used in clinical practice. This study tested the effectiveness of an intervention to increase physicians' use of the CAGE questions.


METHODS
We reviewed medical records charts completed by 15 family practice residents for documented alcoholism screening, both before and after an educational intervention. The intervention included modification of examination forms to include the CAGE questions, as well as written feedback from faculty members regarding residents' documentation of alcohol screening.


RESULTS
We reviewed a total of 170 pre- and 227 post-intervention charts. Following educational intervention, documentation of quantity/frequency of alcohol beverage consumption increased from 26.5% to 93%. The use of CAGE screening increased from 5.9% to 76.7%. For post-intervention charts that documented using the four CAGE questions, 12.6% showed one or more positive responses. Of these charts, 27% documented physician intervention such as a warning or referral for treatment of alcohol-related problems.


CONCLUSIONS
Our educational intervention was a successful way to improve physicians' use of CAGE questions to screen for alcoholism.
Lawner
K
K
Department of Family Practice, Lutheran General Hospital/Advocate, Park Ridge, Ill, USA.
Doot
M
M
Gausas
J
J
Doot
J
J
See
C
C
D000437:Alcoholism / Q000517:prevention & control*; D016009:Chi-Square Distribution; D004282:Documentation; D005194:Family Practice / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D008137:Longitudinal Studies; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D011364:Professional Practice / Q000592:standards*; D015397:Program Evaluation