Determinants of Early Reductions in Drinking in Older At-Risk Drinkers Participating in the Intervention Arm of a Trial to Reduce At-Risk Drinking in Primary Care

Authors

  • James C. Lin MD, MBA,

    1. From the *Special Fellowship in Advanced Geriatrics, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, Cheng Ching Hospital, Taichung, Taiwan; Integrated Substance Abuse Programs, Department of Medicine, David Geffen School of Medicine, and #Health Services Research Center, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California; and §Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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  • Mitchell P. Karno PhD,

    1. From the *Special Fellowship in Advanced Geriatrics, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, Cheng Ching Hospital, Taichung, Taiwan; Integrated Substance Abuse Programs, Department of Medicine, David Geffen School of Medicine, and #Health Services Research Center, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California; and §Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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  • Kristen L. Barry PhD,

    1. From the *Special Fellowship in Advanced Geriatrics, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, Cheng Ching Hospital, Taichung, Taiwan; Integrated Substance Abuse Programs, Department of Medicine, David Geffen School of Medicine, and #Health Services Research Center, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California; and §Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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  • Frederic C. Blow PhD,

    1. From the *Special Fellowship in Advanced Geriatrics, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, Cheng Ching Hospital, Taichung, Taiwan; Integrated Substance Abuse Programs, Department of Medicine, David Geffen School of Medicine, and #Health Services Research Center, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California; and §Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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  • James W. Davis MD,

    1. From the *Special Fellowship in Advanced Geriatrics, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, Cheng Ching Hospital, Taichung, Taiwan; Integrated Substance Abuse Programs, Department of Medicine, David Geffen School of Medicine, and #Health Services Research Center, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California; and §Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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  • Lingqi Tang PhD,

    1. From the *Special Fellowship in Advanced Geriatrics, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, Cheng Ching Hospital, Taichung, Taiwan; Integrated Substance Abuse Programs, Department of Medicine, David Geffen School of Medicine, and #Health Services Research Center, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California; and §Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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  • Alison A. Moore MD, MPH

    1. From the *Special Fellowship in Advanced Geriatrics, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California; Department of Medicine, Cheng Ching Hospital, Taichung, Taiwan; Integrated Substance Abuse Programs, Department of Medicine, David Geffen School of Medicine, and #Health Services Research Center, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California; and §Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
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Address correspondence to James C. Lin, 11301 Wilshire Ave, Building 220, Room 302, Los Angeles, CA 90073. E-mail: jlin1207@ucla.edu

Abstract

OBJECTIVES: To describe differences between older at-risk drinkers, as determined using the Comorbidity Alcohol Risk Evaluation Tool, who reduced drinking and those who did not after an initial intervention and to determine factors associated with early reductions in drinking.

DESIGN: Secondary analyses of data from a randomized controlled trial.

SETTING: Seven primary care sites.

PARTICIPANTS: Subjects randomized to the intervention group who completed the first health educator call approximately 2 weeks after enrollment (n=239).

INTERVENTION: Personalized risk reports, booklets on alcohol-associated risks, and advice from physicians, followed by a health educator call.

MEASURMENTS: Reductions in number of alcoholic drinks.

RESULTS: Thirty-nine percent of the sample had reduced drinking within 2 weeks of receiving the initial intervention. According to the final multiple logistic regression model, those who were concerned about alcohol-related risks (odds ratio (OR)=2.03, 95% confidence interval (CI)=1.01–4.07), read through the educational booklet (OR=2.97, 95% CI=1.48–5.95), or perceived that their physicians discussed risks and advised changing drinking behaviors (OR=4.1, 95% CI=2.02–8.32) had greater odds of reducing drinking by the first health educator call.

CONCLUSION: Concern about risks, reading educational material, and perception of physicians providing advice to reduce drinking were associated with early reductions in alcohol use in older at-risk drinkers. Understanding these factors will enable development of better intervention strategies to reduce unhealthy alcohol use.

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