title: Alcohol misuse and multiple sclerosis.
abstract: OBJECTIVE
  To describe the prevalence of alcohol misuse and medical advice to reduce drinking in a national sample of veterans with multiple sclerosis (MS).
  
  
  METHODS
  Cross-sectional cohort study linking computerized medical record information to mailed survey data from 2004 through 2006.
  
  
  METHODS
  Veterans Health Administration (VHA).
  
  
  METHODS
  Two thousand six hundred fifty-five of 4929 veterans with MS who received services in VHA between 2004 and 2006 and also a survey questionnaire (53.9% response rate).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Demographic information, Short-Form 12-Item Health Survey Mental Component Summary and Physical Component Summary, Alcohol Use Disorders Identification Test Consumption questions, and questions assessing depressive symptoms and the receipt of alcohol-related advice from a medical professional.
  
  
  RESULTS
  Among all survey respondents with MS, the prevalence of alcohol misuse for the sample was 13.9% (confidence interval [CI], 12.5-15.2), with 11.9% (CI, 10.6-13.2) and 2.0% (CI, 1.4-2.5) of participants scoring in the mild/moderate and severe range of alcohol misuse, respectively. In contrast to community samples there was no difference in prevalence by sex. In multivariate logistic regression, age younger than 60 years (<50y; adjusted odds ratio [AOR]=1.66; CI, 1.17-2.37, and 50-59; AOR=1.64; CI, 1.19-2.27), employment (AOR=1.54; CI, 1.06-2.24) and better physical health (AOR=1.02; CI, 1.01-1.04) were associated with a higher likelihood of alcohol misuse. Among persons who screened positive for alcohol misuse, only 26.2% (CI, 21.5-30.9) reported they had received advice from a medical provider in the past year to decrease or abstain from drinking. Self-report of advice was more likely among those endorsing severe misuse (AOR=3.65; CI, 1.85-7.17) and less likely among those with better mental health (AOR=0.97; CI, 0.94-1.00).
  
  
  CONCLUSIONS
  Despite the numerous health and social consequences of alcohol misuse, routine screening and intervention for people with MS remain uncommon. Brief screening and advice to reduce or refrain from alcohol use can be accomplished in as little as 5 minutes and can be incorporated into the regular course of medical care.
authors.affiliation: Veterans Affairs Puget Sound Health Care System, Rehabilitation Care Services, University of Washington, Seattle, WA 98108, USA. Aaron.Turner@va.gov
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Turner
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Hawkins
authors.forename: Jodie K
authors.initials: JK
authors.lastname: Haselkorn
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Kivlahan
mesh_terms: D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000453:epidemiology*; D015331:Cohort Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006787:Hospitals, Veterans; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation*; D016017:Odds Ratio; D015995:Prevalence; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires