title: Screening for problem drinking: impact on physician behavior and patient drinking habits.
abstract: OBJECTIVE
  To assess the effect of a screen for problem drinking on medical residents and their patients.
  
  
  METHODS
  Descriptive cohort study.
  
  
  METHODS
  Veterans Affairs Medical Clinic.
  
  
  METHODS
  Patients were screened 2 weeks before a scheduled visit (n = 714). Physicians were informed if their patients scored positive.
  
  
  RESULTS
  Physician discussion of alcohol use was documented through patient interview and chart review. Self-reported alcohol consumption was recorded. Of 236 current drinkers, 28% were positive for problem drinking by the Alcohol Use Disorders Identification Test (AUDIT). Of 58 positive patients contacted at 1 month, 78% recalled a discussion about alcohol use, 58% were advised to decrease drinking, and 9% were referred for treatment. In 57 positive patient charts, alcohol use was noted in 33 (58%), and a recommendation in 14 (25%). Newly identified patients had fewer notations than patients with prior alcohol problems. Overall, 6-month alcohol consumption decreased in both AUDIT-positive and AUDIT-negative patients. The proportion of positive patients who consumed more than 16 drinks per week (problem drinking) decreased from 58% to 49%. Problem drinking at 6 months was independent of physician discussion or chart notation.
  
  
  CONCLUSIONS
  Resident physicians discussed alcohol use in a majority of patients who screened positive for alcohol problems but less often offered specific advice or treatment. Furthermore, residents were less likely to note concerns about alcohol use in charts of patients newly identified. Finally, a screen for alcohol abuse may influence patient consumption.
authors.affiliation: Section of General Internal Medicine, VA Pittsburgh Health Care System, Center for Research on Healthcare, University of Pittsburgh, PA 15240, USA.
authors.forename: J
authors.initials: J
authors.lastname: Conigliaro
authors.forename: R P
authors.initials: RP
authors.lastname: Lofgren
authors.forename: B H
authors.initials: BH
authors.lastname: Hanusa
mesh_terms: D000428:Alcohol Drinking; D000437:Alcoholism / Q000175:diagnosis*; D006801:Humans; D007396:Internship and Residency; D008875:Middle Aged; D011320:Primary Health Care; D014481:United States