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J Gen Intern Med. 2002 May;17(5):315-26.

Alcohol-related discussions during general medicine appointments of male VA patients who screen positive for at-risk drinking.

Author information

  • 1Northwest Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle, WA 98108, USA. willi@u.washington.edu

Abstract

OBJECTIVE:

This study describes primary care discussions with patients who screened positive for at-risk drinking. In addition, discussions about alcohol use from 2 clinic firms, one with a provider-prompting intervention, are compared.

DESIGN:

Cross-sectional analyses of audiotaped appointments collected over 6 months.

PARTICIPANTS AND SETTING:

Male patients in a VA general medicine clinic were eligible if they screened positive for at-risk drinking and had a general medicine appointment with a consenting provider during the study period. Participating patients ( N = 47) and providers ( N = 17) were enrolled in 1 of 2 firms in the clinic (Intervention or Control) and were blinded to the study focus.

INTERVENTION:

Intervention providers received patient-specific results of positive alcohol-screening tests at each visit.

MEASURES AND MAIN RESULTS:

Of 68 visits taped, 39 (57.4%) included any mention of alcohol. Patient and provider utterances during discussions about alcohol use were coded using Motivational Interviewing Skills Codes. Providers contributed 58% of utterances during alcohol-related discussions with most coded as questions (24%), information giving (23%), or facilitation (34%). Advice, reflective listening, and supportive or affirming statements occurred infrequently (5%, 3%, and 5%, of provider utterances respectively). Providers offered alcohol-related advice during 21% of visits. Sixteen percent of patient utterances reflected "resistance" to change and 12% reflected readiness to change. On average, Intervention providers were more likely to discuss alcohol use than Control providers (82.4% vs 39.6% of visits; P =.026).

CONCLUSIONS:

During discussions about alcohol, general medicine providers asked questions and offered information, but usually did not give explicit alcohol-related advice. Discussions about alcohol occurred more often when providers were prompted.

Comment in

PMID:
12047727
PMCID:
PMC1495044
[PubMed - indexed for MEDLINE]
Free PMC Article
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