Shadow Health Papers
Screening Adults for Unhealthy Alcohol Use in a Primary Healthcare Setting
Results
The study recorded a total of 100 adult patients who visited the healthcare facility within the two months. Most visits lasted less than 30 minutes based on the nature of the patient’s conditions. Of the 100 recorded visits, less than a third were for preventive care and the majority were those assigned to specific primary care physicians. Data analysis was done using three key statistical measures including percentages, odds ratio, and confidence intervals. The percentages were used to determine the relationship between the patient characteristics observed during the study (Ranganathan, 2021). Adjusted odds ratios were used to give a dynamic view of the predictors and to determine the odds of exposure among case patients. For example, odds ratios were used to examine age-specific exposure to alcohol use. Lastly, the confidence interval measure was used to measure uncertainty inside the patient characteristics.
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The demographic and clinical characteristics of patients seen in vistis are presented in the table 1 below.
Characteristic | Percentage (n) |
Sex | |
Male | 42.0% (42) |
Female | 58.0% (58) |
Age (Years) | |
18-24 | 5.5% (5) |
25-40 | 21.5% (22) |
41-64 | 37.2% (37) |
65 and above | 35.8% (36) |
Race /ethnicity | |
White, non-Hispanic | 67.0% (67) |
Black | 13.0% (13) |
Hispanic | 15% (15) |
Other | 5% (5) |
Alcohol screening using AUDIT was documented in majority of the visits. Among the screened patients, the need for referral for special care and behavioral counseling was observed in 100 adult patients which served as the study population. Patients were more likely to be screened for alcohol use if they were seen by their primary care physicians with those presented with new problems were less likely to be screened. Table 2 below demonstrates variables associated with addressing alcohol use when screening was done using AUDIT.
Characteristic | Adjusted OR | 95% CI |
Sex | ||
Male | 1.0 | |
Female | 1.09 | 0.81, 1.47 |
Age (Years) | ||
18-24 | 1.0 | |
25-40 | 1.24 | 0.48, 3.16 |
41-64 | 1.10 | 0.44, 2.75 |
65 and above | 0.94 | 0.38, 2.31 |
Race /ethnicity | ||
White, non-Hispanic | 1.0 | |
Black | 0.83 | 0.53, 1.26 |
Hispanic | 1.33 | 0.67, 2.66 |
Other | 0.32 | 0.08, 1.21 |
Seen by primary care | ||
No | 1.0 | |
Yes | 4.38 | 1.41, 13.61 |
In summary, a total of 100 patients were seen over the 8 weeks study period. These included 42 male and 58 female patients seeking care in the primary care facility. Because of the varied nature of the visits, all patients seen qualified for alcohol screening using AUDIT. These included patients with an AUDIT score of 8 and above. Those patients who were not eligible for referral were offered brief counseling to endure change in alcohol intake behaviors. A total of 100 patients were found to have issues related to alcohol use and were referred to behavioral counseling. To ascertain compliance with the screening and referral process, records about the number of patients attending counseling sessions were kept. Out of the 100 patients referred for behavioral counseling, 72 patients (72%) successfully completed the counseling sessions.
Conclusions
The AUDIT tool is a simple and effective measure of screening for alcohol use. This tool provides a framework for intervention and helps healthcare providers to identify at-risk populations who may require special care. This study examined the relevance of alcohol screening using AUDIT in improving compliance with behavioral counseling. The primary purpose was to screen patients using AUDIt and use the results to recommend behavioral counseling for patients. Overall, the study screened 100 patients within 8 weeks and identified 100 patients who required behavioral counseling using the AUDIT screening tool. Upon conclusion of the study, it was observed that AUDIT improved compliance with behavioral counseling by ensuring 72% (72) of the patients attended counseling sessions. These findings were consistent with other studies that found AUDIT a reliable and effective tool for detecting alcohol dependence (Coste et al., 2020; Verhoog et al., 2020). The tool also helped primary care providers to offer brief counseling sessions to many other patients who demonstrated moderate alcohol intake behaviors.
Clinical Relevance
Evidence-based approaches to the screening and referral of patients for unhealthy alcohol use are required in primary care facilities. AUDIT is among the commonly used tools for alcohol screening but little is known of its relevance to behavioral counseling interventions upon screening (Chatterton et al., 2022). This study demonstrates that AUDIT can be used for screening patients in primary care and the results are used to guide the referral of patients for behavioral counseling. This study is relevant to nursing practice because it allows nurses to routinely screen adult patients for alcohol use and refer them for counseling. Secondly, this study demonstrates that frequent screening for alcohol use among adults can be the most appropriate measure to manage heavy alcohol intake. The study also allowed primary care physicians to offer brief counseling to those with AUDIT scores less than 8. I would like to recommend to leaders in the nursing field to implement the screening of alcohol using AUDIT because it can improve compliance with behavioral counseling practices in primary care settings.
References
Chatterton, B., Agnoli, A., Schwarz, E. B., & Fenton, J. J. (2022). Alcohol Screening During US Primary Care Visits, 2014–2016. Journal of General Internal Medicine, 37(15), 3848-3852.
Coste, S., Gimenez, L., Comes, A., Abdelnour, X., Dupouy, J., & Escourrou, E. (2020). Discussing alcohol use with the GP: A qualitative study. BJGP Open, 4(2), bjgpopen20X101029. https://doi.org/10.3399/bjgpopen20X101029
Ranganathan P. (2021). An Introduction to Statistics: Choosing the Correct Statistical Test. Indian journal of critical care medicine : Peer-reviewed, official publication of Indian Society of Critical Care Medicine, 25(Suppl 2), S184–S186. https://doi.org/10.5005/jp-journals-10071-23815
Verhoog, S., Dopmeijer, J. M., de Jonge, J. M., van der Heijde, C. M., Vonk, P., Bovens, R. H. L. M., de Boer, M. R., Hoekstra, T., Kunst, A. E., Wiers, R. W., & Kuipers, M. A. G. (2020). The use of the alcohol use disorders identification test – consumption as an indicator of hazardous alcohol use among university students. European Addiction Research, 26(1), 1–9.
https://doi.org/10.1159/000503342
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