title: Correlates of alcohol-related discussions between older adults and their physicians.
abstract: OBJECTIVE
  To identify predictors of alcohol-related patient-physician discussions.
  
  
  METHODS
  Cross-sectional study using baseline data from a randomized controlled trial.
  
  
  METHODS
  Community-based group practice.
  
  
  METHODS
  Thirty-one physicians in Project Senior Health and Alcohol Risk Education and 3,305 of their patients aged 60 and older who use alcohol and completed a survey that included the Comorbidity Alcohol Risk Evaluation Tool (CARET).
  
  
  METHODS
  At study baseline, older adults were asked whether alcohol-related discussions with a physician had occurred in the prior year. This outcome was modeled using logistic regression models with physician random effects. Predictor variables included patient-level variables such as demographics and seven CARET-defined risk factors, specifically a medical or psychiatric comorbidity that alcohol might worsen, a potentially alcohol-related symptom, use of a medication that may interact negatively with alcohol, excessive quantity or frequency of alcohol use, binge drinking, concern from others about drinking, and drinking and driving. Physician-level predictors (age, sex, years since graduation, specialty) were also included.
  
  
  RESULTS
  The probability of reporting alcohol-related discussions declined with patient age (e.g., odds ratio (OR)=0.40 for patients aged ≥80) and was significantly lower for Latinos (OR=0.38). Drinking and driving (OR=1.69) or concern from others (OR=6.04) were significantly associated with alcohol-related discussions; having comorbidities or using medications that may interact with alcohol were not.
  
  
  CONCLUSIONS
  Although patient demographics, including age and ethnicity, are associated with the occurrence of alcohol-related discussions, clinical factors that may negatively interact with alcohol to increase risk are not. This suggests that physicians may not be attuned to the entire spectrum of alcohol-related risks for older adults.
authors.affiliation: Division of General Internal Medicine, Health Services Research, University of California at Los Angeles, Los Angeles, California 90024, USA. kduru@mednet.ucla.edu
authors.forename: O Kenrik
authors.initials: OK
authors.lastname: Duru
authors.forename: Haiyong
authors.initials: H
authors.lastname: Xu
authors.forename: Chi-Hong
authors.initials: CH
authors.lastname: Tseng
authors.forename: Michelle
authors.initials: M
authors.lastname: Mirkin
authors.forename: Alfonso
authors.initials: A
authors.lastname: Ang
authors.forename: Louise
authors.initials: L
authors.lastname: Tallen
authors.forename: Alison A
authors.initials: AA
authors.lastname: Moore
authors.forename: Susan L
authors.initials: SL
authors.lastname: Ettner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects / Q000517:prevention & control*; D000437:Alcoholism / Q000517:prevention & control* / Q000534:rehabilitation; D002140:California; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010353:Patient Education as Topic; D010819:Physician's Role; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires