An evaluation of an intervention to assist primary care physicians in screening and educating older patients who use alcohol.

OBJECTIVES

To evaluate whether providing physicians and older patients with personalized reports of drinking risks and benefits and patient education reduces alcohol-related risks and problems.

DESIGN

Prospective comparison study.

SETTING

Community primary care.

PARTICIPANTS

Twenty-three physicians and 665 patients aged 65 and older.

INTERVENTION

Combined report, in which six physicians and 198 [corrected] patients received reports of patients' drinking classifications and patients also received education; patient report, in which 245 patients received reports and education, but their five physicians did not receive reports; and usual care.

MEASUREMENTS

Assessments at baseline and 12 months later to determine patients' nonhazardous (no known risks), hazardous (risks for problems), or harmful (presence of problems) classifications using the Computerized Alcohol-Related Problems Survey (CARPS). The CARPS contains a scanned screening measure and scoring algorithms and automatically produces patient and physician reports and patient education.

RESULTS

At baseline, 21% were harmful drinkers, and 26% were hazardous drinkers. The patient report and combined report interventions were each associated with greater odds of lower-risk drinking at follow-up than usual care (odds ratio=1.59 and 1.23, respectively, P<.05 for each). The patient report intervention significantly reduced harmful drinking at follow-up from an expected 21% in usual care to 16% and increased nonhazardous drinking from 52% expected in usual care to 58%. Patients in the combined report intervention experienced a significantly greater average decrease in quantity and frequency.

CONCLUSION

Older primary care patients can effectively reduce their alcohol consumption and other drinking risks when given personalized information about their drinking and health.