title: Alcohol counseling reflects higher quality of primary care.
abstract: BACKGROUND
  Some primary care physicians do not conduct alcohol screening because they assume their patients do not want to discuss alcohol use.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  A prospective cohort study.
  
  
  METHODS
  Two hundred eighty-eight patients in an academic primary care practice who had unhealthy alcohol use.
  
  
  METHODS
  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.
authors.affiliation: Clinical Addiction Research and Education Unit, Section of General Internal Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA 02118, USA. rsaitz@bu.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Saitz
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Horton
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Cheng
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis / Q000628:therapy*; D037001:Directive Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000592:standards*; D011446:Prospective Studies; D011787:Quality of Health Care