Alcohol-related Discussions during General Medicine Appointments of Male VA Patients Who Screen Positive for At-risk Drinking
Article first published online: 31 MAY 2002
Journal of General Internal Medicine
Volume 17, Issue 5, pages 315–326, May 2002
How to Cite
Bradley, K. A., Epler, A. J., Bush, K. R., Sporleder, J. L., Dunn, C. W., Cochran, N. E., Braddock, C. H., McDonell, M. B. and Fihn, S. D. (2002), Alcohol-related Discussions during General Medicine Appointments of Male VA Patients Who Screen Positive for At-risk Drinking. Journal of General Internal Medicine, 17: 315–326. doi: 10.1046/j.1525-1497.2002.10618.x
- Issue published online: 31 MAY 2002
- Article first published online: 31 MAY 2002
- primary care;
- brief interventions;
- motivational interviewing
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.