MMWR Morb Mortal Wkly Rep. 2020 Mar 13;69(10):265-270. doi: 10.15585/mmwr.mm6910a3.
Binge drinking* is a leading preventable public health problem. From 2006 to 2010, binge drinking contributed to approximately 49,000 annual deaths resulting from acute conditions (e.g., injuries and violence) (1). Binge drinking also increases the risk for adverse health conditions, including some chronic diseases (e.g., breast cancer) and fetal alcohol spectrum disorders (2). In 2004, 2013, and again in 2018, for all U.S. adults aged ≥18 years in primary care, the U.S. Preventive Services Task Force (USPSTF) recommended alcohol screening and brief intervention (alcohol SBI) or counseling for persons whose screening indicated drinking in excess of recommended limits or in ways that increase risk for poor health outcomes (3-5). However, previous CDC surveillance data indicate that patients report rarely talking to their provider about alcohol use, and alcohol SBI is traditionally delivered through conversation. CDC recently analyzed 2017 data from the Behavioral Risk Factor Surveillance System (BRFSS) survey's five-question module, which asked adults in 13 states and the District of Columbia (DC) about the delivery of alcohol SBI during their most recent checkup in the past 2 years. Overall, 81.4% of adults (age-standardized estimate) reported being asked about alcohol use by a health professional in person or on a form during a checkup in the past 2 years, but only 37.8% reported being asked a question about binge-level alcohol consumption, which is included on USPSTF recommended instruments (3). Among module respondents who were asked about alcohol use at a checkup in the past 2 years and reported current binge drinking (past 30 days) at time of survey, only 41.7% were advised about the harms of drinking too much at a checkup in the past 2 years, and only 20.1% were advised to reduce or quit drinking at a checkup in the past 2 years. These findings suggest that missed opportunities remain for health care providers to intervene with patients who report binge drinking. Working to implement alcohol SBI at a systems level, including the provision of the new Healthcare Effectiveness Data Information Set (HEDIS) measure, Unhealthy Alcohol Use Screening and Follow-Up, can improve alcohol SBI's use and benefit in primary care.
binge drinking* 是一个主要的可预防的公共卫生问题。从 2006 年到 2010 年， binge drinking* 导致了大约 49000 人每年因急性疾病（例如伤害和暴力）而死亡。 binge drinking* 还会增加不良健康状况的风险，包括一些慢性疾病（例如乳腺癌）和胎儿酒精谱系障碍。2004 年、2013 年和 2018 年，对于所有美国≥18 岁的初级保健成年人，美国预防服务工作组（USPSTF）建议对筛查显示饮酒超过推荐限量或增加不良健康后果风险的人进行酒精筛查和简短干预（酒精 SBI）或咨询（3-5）。然而，之前的 CDC 监测数据表明，患者很少向他们的医生报告饮酒情况，而酒精 SBI 传统上是通过对话来提供的。CDC 最近分析了 2017 年来自行为风险因素监测系统（BRFSS）调查的五个问题模块的数据，该模块询问了 13 个州和哥伦比亚特区（DC）的成年人在过去 2 年内最近一次体检期间是否接受了酒精 SBI。总体而言，81.4%的成年人（年龄标准化估计）报告在过去 2 年内的体检中，医生通过面对面或表格询问过他们的饮酒情况，但只有 37.8%的人报告被问到关于 binge-level 饮酒量的问题，这是 USPSTF 推荐的工具包括的内容（3）。在过去 2 年内接受过体检并在调查时报告当前 binge drinking*（过去 30 天）的模块受访者中，只有 41.7%的人在过去 2 年内的体检中被告知饮酒过多的危害，只有 20.1%的人在过去 2 年内的体检中被告知减少或戒酒。这些发现表明，卫生保健提供者仍然有机会对报告 binge drinking*的患者进行干预。努力在系统层面实施酒精 SBI，包括提供新的医疗保健效果数据信息集（HEDIS）措施，即“不健康酒精使用筛查和随访”，可以提高酒精 SBI 在初级保健中的使用和效益。
