An evaluation of an intervention to assist primary care physicians in screening and educating older patients who use alcohol.
OBJECTIVE
To evaluate whether providing physicians and older patients with personalized reports of drinking risks and benefits and patient education reduces alcohol-related risks and problems.


METHODS
Prospective comparison study.


METHODS
Community primary care.


METHODS
Twenty-three physicians and 665 patients aged 65 and older.


METHODS
Combined report, in which six physicians and 198 [corrected] patients received reports of patients' drinking classifications and patients also received education; patient report, in which 245 patients received reports and education, but their five physicians did not receive reports; and usual care.


METHODS
Assessments at baseline and 12 months later to determine patients' nonhazardous (no known risks), hazardous (risks for problems), or harmful (presence of problems) classifications using the Computerized Alcohol-Related Problems Survey (CARPS). The CARPS contains a scanned screening measure and scoring algorithms and automatically produces patient and physician reports and patient education.


RESULTS
At baseline, 21% were harmful drinkers, and 26% were hazardous drinkers. The patient report and combined report interventions were each associated with greater odds of lower-risk drinking at follow-up than usual care (odds ratio=1.59 and 1.23, respectively, P<.05 for each). The patient report intervention significantly reduced harmful drinking at follow-up from an expected 21% in usual care to 16% and increased nonhazardous drinking from 52% expected in usual care to 58%. Patients in the combined report intervention experienced a significantly greater average decrease in quantity and frequency.


CONCLUSIONS
Older primary care patients can effectively reduce their alcohol consumption and other drinking risks when given personalized information about their drinking and health.
Fink
Arlene
A
David Geffen School of Medicine, School of Public Health, University of California at Los Angeles, Los Angeles, California, USA. afink@mednet.ucla.edu
Elliott
Marc N
MN
Tsai
Mark
M
Beck
John C
JC
D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology / Q000517:prevention & control*; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000517:prevention & control; D000437:Alcoholism / Q000453:epidemiology / Q000517:prevention & control*; D002140:California; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D015999:Multivariate Analysis; D010353:Patient Education as Topic; D011320:Primary Health Care; D011446:Prospective Studies; D018570:Risk Assessment