WRITER: LENA BAKER
CONTACT: DAVE PEDERSEN
Iowa City IA 52242
(319) 335-8032; fax (319) 384-4638
Release: Jan. 15, 2002
Study: Primary Care Physicians Need To Screen For Alcohol Problems
Physicians speak with patients less frequently about
alcohol use than about other health-related behaviors, according to a study
by researchers at the University of Iowa department of psychiatry.
This new finding, in a study published in the January
issue of the Journal of Family Practice, is one of the first of its kind,
said Stephan Arndt, Ph.D., professor in the UI department of psychiatry and
lead author of the study. Arndt also is director of the Iowa Consortium for
Substance Abuse Research and Evaluation, based at the UI Oakdale Research
Campus. The study was funded in part by the consortium.
"The goal of this study was to look at how often primary
care physicians screened for alcohol problems among their patients," Arndt
said. "While studies have been done on primary care physicians screening for
illegal drugs, not many studies have focused on alcohol use."
The data were based on telephone interviews conducted
by the 1997 Behavioral Risk Factors Surveillance System (BRFSS), an annual
surveying system of the U.S. Centers for Disease Control and Prevention that
involved a random sample of people living within the United States. The study
selected 23,349 adults, ages 18 and older, who reported having a routine physical
examination within the past three years.
The survey looked to find out which patients were
assessed for excessive alcohol use and what characteristics predicted the
assessment, and how often did discussions about alcohol occur compared with
other health risk discussions such as eating habits or smoking.
Arndt and his colleagues found that about one in six
patients reported that a physician or other health care worker had initiated
a discussion about alcohol use. Men, nonwhites, and uneducated, low income,
unmarried and young patients were asked more frequently about alcohol use.
Interestingly, whites reported a higher consumption of alcohol, as did higher
income and educated patients. While divorced patients reported discussions
about alcohol use frequently,
widowed patients reported them least often. Women, and
especially widowed women, were rarely asked about their alcohol use. Researchers
found that physicians tended to ask patients about AIDS, smoking and other
health-related behaviors more than alcohol use.
More than one in nine people in the sample met criteria
for excessive drinking (consuming 60 or more drinks per month or five or more
drinks in a single occasion in the past month). Based on this definition,
slightly more than one in four excessive drinkers reported a discussion about
alcohol with a physician.
One reason physicians don't ask about alcohol use
is that many physicians feel they are not trained to recognize and deal with
alcohol problems, Arndt said.
He noted that the study findings are important in
order to help prevent alcohol problems in the United States.
"Money is spent every year trying to clean up alcohol
problems in this country," Arndt said. "Instead, this money should be spent
on prevention. Just a few minutes of asking questions about someone's alcohol
use can have a huge impact."
Referring an at-risk patient to a treatment center
or drug rehabilitation counselor is effective in preventing significant alcohol
problems, Arndt said.
University of Iowa Health Care describes the partnership
between the UI College of Medicine and the UI Hospitals and Clinics and the
patient care, medical education and research programs and services they provide.