Readiness to Change In Primary Care Patients Who Screened Positive for Alcohol Misuse (original) (raw)
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Addictive Behaviors, 2005
Brief primary care interventions for alcohol use should be tailored to patients' readiness to change; however, validated measures of readiness to change are too lengthy to be practical in most primary care settings. We compared a readiness to change drinking algorithm (RTC Algorithm) based on three standardized questions to a validated 12-item readiness to change questionnaire (Rollnick RTCQ) in 85 hazardous drinking female Veterans Affairs (VA) patients. Results from comparisons of mean Rollnick RTCQ scale scores across RTC Algorithm categories suggest good concurrent validity. Regular assessment using the RTC Algorithm questions may help primary care providers tailor alcohol-related discussions with hazardous drinking patients. D
Ethnicity & disease, 2008
The high rate of alcohol use among emergency department (ED) patients makes the ED setting an obvious target for increased screening and interventions. However, interventions to change alcohol behavior may be applied inappropriately if a patient's motivation to change is not factored in. In this study, we identify correlates of readiness to change problem drinking among a sample of ED patients with problem drinking. Cross-sectional study of 295 ED patients who scored positive for alcohol problems on the CAGE questionnaire (score > or = 1). Study measures include illicit drug use, exposure to violence, and having a primary care doctor as the main predictor variables and level of readiness to change problem drinking as the outcome measure. Participants were 64% African American, 30% Latino, and 80% male; 46% had less than a high school diploma; 85% were not married; 72% had no health insurance; and 85% had no primary care provider. Whereas 12% of patients were not ready to chan...
Treatment Preferences among Problem Drinkers in Primary Care
International Journal of Psychiatry in Medicine, 2014
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. Method: 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 231
Managing Problem Drinking: Screening Tools and Brief Interventions for Primary Care Physicians
A high percentage of patients seen in primary care clinics partake in excessive alcohol consumption. It leads to numerous health problems and remains one of the leading risk factors for chronic disease. Despite the health concerns, screening for and intervening in patients’ alcohol misuse has yet to become standard practice in many primary care settings. There is well- established empirical evidence that brief doctor-patient interactions reduce alcohol consumption among excessive drinkers in primary care settings. This article draws on randomized controlled trials and literature on screening techniques, motivational interviewing, the transtheoretical model of behavior change, and medication-assisted treatments to enhance brief intervention methodology. Through this review, evidence-based practical strategies are presented to primary care doctors that reduce alcohol consumption in patients screened as problem drinkers. Referral information for those individuals with severe drinking problems is included. We propose that short, multicomponent interventions are most effective when they include interventions that utilize the lifestyle medicine philosophy, a nonjudgmental therapeutic alliance, and account for patient concerns more directly.
Alcoholism: Clinical and Experimental Research, 1998
To determine the reliability, validity, and responsiveness to change of AUDIT (Alcohol Use Disorders Identification Test) questions 1 to 3 about alcohol consumption in a primary care setting. Randomly selected, male general medical patients (n = 441) from three VA Medical Centers, who had 5 or more drinks containing alcohol in the past year and were willing to be interviewed about their health habits. Three self-administered AUDIT consumption questions were compared with a telephone-administered version of the trilevel World Health Organization interview about alcohol consumption. Of 393 eligible patients, 264 (67%) completed interviews. Test-retest reliability--Correlations between baseline and repeat measures 3 months later for four dimensions of consumption according to the AUDIT, ranged from 0.65 to 0.85, among patients who indicated they had not changed their drinking (Kendall's Tau-b). Criterion validity--Correlations between AUDIT and interview for four dimensions of alcohol consumption ranged from 0.47 to 0.66 (Kendall's Tau-b). Discriminative validity--The AUDIT questions were specific (90 to 93%), but only moderately sensitive (54 to 79%), for corresponding criteria for heavy drinking. Responsiveness to change--The AUDIT consumption questions had a Guyatt responsiveness statistic of 1.04 for detecting a change of 7 drinks/week, suggesting excellent responsiveness to change. AUDIT questions 1 to 3 demonstrate moderate to good validity, but excellent reliability and responsiveness to change. Although they often underestimate heavy alcohol consumption according to interview, they performed adequately to be used as a proxy measure of consumption in a clinical trial of heavy drinkers in this population.