Factors associated with favorable drinking outcome 12 months after hospitalization in a prospective cohort study of inpatients with unhealthy alcohol use.
BACKGROUND
Prevalence of unhealthy alcohol use among medical inpatients is high.


OBJECTIVE
To characterize the course and outcomes of unhealthy alcohol use, and factors associated with these outcomes.


METHODS
Prospective cohort study.


METHODS
A total of 287 medical inpatients with unhealthy alcohol use.


METHODS
At baseline and 12 months later, consumption and alcohol-related consequences were assessed. The outcome of interest was a favorable drinking outcome at 12 months (abstinence or drinking "moderate" amounts without consequences). The independent variables evaluated included demographics, physical/sexual abuse, drug use, depressive symptoms, alcohol dependence, commitment to change (Taking Action), spending time with heavy-drinking friends and receipt of alcohol treatment (after hospitalization). Adjusted regression models were used to evaluate factors associated with a favorable outcome.


RESULTS
Thirty-three percent had a favorable drinking outcome 1 year later. Not spending time with heavy-drinking friends [adjusted odds ratio (AOR) 2.14, 95% CI: 1.14-4.00] and receipt of alcohol treatment [AOR (95% CI): 2.16(1.20-3.87)] were associated with a favorable outcome. Compared to the first quartile (lowest level) of Taking Action, subjects in the second, third and highest quartiles had higher odds of a favorable outcome [AOR (95% CI): 3.65 (1.47, 9.02), 3.39 (1.38, 8.31) and 6.76 (2.74, 16.67)].


CONCLUSIONS
Although most medical inpatients with unhealthy alcohol use continue drinking at-risk amounts and/or have alcohol-related consequences, one third are abstinent or drink "moderate" amounts without consequences 1 year later. Not spending time with heavy-drinking friends, receipt of alcohol treatment and commitment to change are associated with this favorable outcome. This can inform efforts to address unhealthy alcohol use among patients who often do not seek specialty treatment.
Bertholet
Nicolas
N
Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA. Nicolas.Bertholet@chuv.ch
Cheng
Debbie M
DM
Palfai
Tibor P
TP
Saitz
Richard
R
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D040242:Risk Reduction Behavior; D013695:Temperance / Q000523:psychology / Q000639:trends; D016896:Treatment Outcome