title: Treatment preferences among problem drinkers in primary care.
abstract: OBJECTIVE
  Alcohol misuse is common among primary care patients, yet many do not receive treatment because doctors believe problem drinkers are "in denial," or are unwilling to change their drinking habits. The real problem, however, may be that patients are being offered treatment modalities that do not meet their needs. This study was designed to measure the acceptability of various treatment options among drinkers who were currently not receiving treatment.
  
  
  METHODS
  Patients in a primary care clinic were given a self-report questionnaire that included: (1) the Alcohol Use Disorders Questionnaire, (2) a measure of readiness to change drinking behavior, and (3) a list of treatment modalities to be rated based on level of interest.
  
  
  RESULTS
  Within a random sample of 402 patients, 40.2% reported high risk drinking and 16.3% reported problem drinking. Among the latter group, 89.3% were either considering change, or had begun to take steps to make changes in their drinking behaviors. When asked about treatment preferences, the modalities most frequently recommended by physicians-group therapy and Alcoholics Anonymous-were among the least acceptable. The most popular options were getting help from a primary care doctor and taking a medication that would make it easier to avoid drinking without making them sick if they drank.
  
  
  CONCLUSIONS
  The belief that problem drinkers are unwilling to change was not supported by this study. Treatment for problem drinking should involve a collaborative evaluation of options with an emphasis on patient preference and treatment within the primary care setting.
authors.affiliation: George Washington University School of Medicine and Health Sciences.
authors.forename: Daniel Z
authors.initials: DZ
authors.lastname: Lieberman
authors.affiliation: George Washington University School of Medicine and Health Sciences.
authors.forename: Anne
authors.initials: A
authors.lastname: Cioletti
authors.affiliation: Northwestern University Feinberg School of Medicine.
authors.forename: Suena H
authors.initials: SH
authors.lastname: Massey
authors.affiliation: Office of Human Research, George Washington University.
authors.forename: Rochelle S
authors.initials: RS
authors.lastname: Collantes
authors.affiliation: George Washington University School of Medicine and Health Sciences.
authors.forename: Brad B
authors.initials: BB
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000436:Alcoholics Anonymous; D000437:Alcoholism / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D003717:Denial, Psychological; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009042:Motivation; D010342:Patient Acceptance of Health Care / Q000523:psychology; D057240:Patient Preference; D011320:Primary Health Care; D011594:Psychometrics; D011615:Psychotherapy, Group; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: alcohol consumption; drug abuse screening; individualized medicine; primary health care; secondary prevention; substance abuse detection