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Research ArticleOriginal Research

Readiness to Change in Primary Care Patients Who Screened Positive for Alcohol Misuse

Emily C. Williams, Daniel R. Kivlahan, Richard Saitz, Joseph O. Merrill, Carol E. Achtmeyer, Kinsey A. McCormick and Katharine A. Bradley
The Annals of Family Medicine May 2006, 4 (3) 213-220; DOI: https://doi.org/10.1370/afm.542
Emily C. Williams
MPH
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Daniel R. Kivlahan
PhD
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Richard Saitz
MD, MPH
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Joseph O. Merrill
MD, MPH
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Carol E. Achtmeyer
MN
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Kinsey A. McCormick
BA
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Katharine A. Bradley
MD, MPH
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    Figure 1.

    Readiness to change of patients enrolled in the study.

  • Figure 2.
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    Figure 2.

    Percentage of male patients in contemplation or action groups by scores on the full 10-item AUDIT (n = 6,419).

    AUDIT = Alcohol Use Disorders Identification Test.

Tables

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    Table 1.

    Demographic Characteristics of Participants (N = 6,419)

    CharacteristicValue
    AUDIT = Alcohol Use Disorders Identification Test; AUDIT-C = 3 AUDIT consumption questions; CAGE = CAGE Questionnaire (cut down, annoyed, guilty, and eye opener).
    * n = 6,261, missing data for 158 subjects.
    † n = 6,269, missing data for 150 subjects.
    Age in years, mean (SD)60 (11.5)
    Race,* No. (%)
        African American1,199 (19)
        White4,081 (64)
        Other981 (15)
    Marital status,† No. (%)
        Never married597 (9)
        Currently married3,163 (49)
        Divorced/separated/widowed2,553 (40)
        Education, some college, No. (%)3,294 (51)
    Annual income, No. (%)
        <$20,0003,769 (58)
        $20,000–$50,0001,946 (30)
        >$50,000704 (11)
    10-item AUDIT score, No. (%)
        1–7 (zone 1)4,083 (64)
        8–15 (zone 2)1,543 (24)
        16–19 (zone 3)290 (5)
        20–40 (zone 4)503 (8)
    AUDIT-C score, No. (%)
        1–32,427 (38)
        4–51,749 (27)
        6–71,031 (16)
        8–9667 (10)
        10–12545 (9)
    CAGE score, No. (%)
        01,595 (25)
        11,424 (22)
        21,598 (25)
        31,095 (17)
        4707 (11)
    • View popup
    Table 2.

    Participants Categorized Into Readiness to Change Groups Stratified by Alcohol Screening Scores

    Alcohol Misuse Severity ScorePrecontemplation n (%)Contemplation n (%)Action n (%)TotalP Value
    AUDIT = Alcohol Use Disorders Identification Test; AUDIT-C = 3 AUDIT consumption questions ; CAGE = CAGE Questionnaire (cut down, annoyed, guilty, and eye opener).
    AUDIT<.001
        <81,518 (37)631 (15)1,934 (47)4,083
        8–1596 (6)535 (35)912 (59)1,543
        16–195 (2)122 (42)163 (56)290
        >203 (1)245 (49)255 (51)503
    AUDIT-C<.001
        1–3956 (39)167 (7)1,304 (54)2,427
        4–5497 (28)444 (25)808 (46)1,749
        6–7113 (11)362 (35)556 (54)1,031
        8–936 (5)278 (42)353 (53)667
        10–1220 (4)282 (52)243 (45)545
    CAGE<.001
        0672 (42)297 (19)626 (39)1,595
        1283 (20)386 (27)755 (53)1,424
        2357 (22)418 (26)823 (52)1,598
        3197 (18)272 (25)626 (57)1,095
        4113 (16)160 (23)434 (61)707

Additional Files

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  • The Article in Brief

    Readiness to Change in Primary Care Patients Who Screen Positive for Alcohol Misuse

    Emily C. Williams, MPH, and colleagues

    Background Alcohol misuse is widespread, and one of the most costly public health problems in the United States. This study of more than 6,000 male patients who reported alcohol misuse in the past year evaluates the participants' readiness to change their alcohol habits.

    What This Study Found Most participants indicated some readiness to change. Contrary to a stereotype that patients with alcohol misuse will deny concerns about their drinking, most patients in this study who reported alcohol misuse indicated that they drank more than they should or had considered or tried decreasing drinking. Those with more severe alcohol misuse were more likely to report readiness to change.

    Implications

    • Primary care clinicians sometimes expect patients to deny their alcohol misuse. Such denial is often thought to be common among patients with the most severe alcohol dependence. The findings in this study suggest that the opposite is true. The more a patient drinks and the more severe his problems because of drinking, the more likely he will report considering or wanting to change his drinking.
    • Based on this and other research, the authors suggest that patients with the least severe alcohol misuse may benefit most from brief alcohol-related advice from their primary care clinicians.
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The Annals of Family Medicine: 4 (3)
The Annals of Family Medicine: 4 (3)
Vol. 4, Issue 3
1 May 2006
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Readiness to Change in Primary Care Patients Who Screened Positive for Alcohol Misuse
Emily C. Williams, Daniel R. Kivlahan, Richard Saitz, Joseph O. Merrill, Carol E. Achtmeyer, Kinsey A. McCormick, Katharine A. Bradley
The Annals of Family Medicine May 2006, 4 (3) 213-220; DOI: 10.1370/afm.542

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Readiness to Change in Primary Care Patients Who Screened Positive for Alcohol Misuse
Emily C. Williams, Daniel R. Kivlahan, Richard Saitz, Joseph O. Merrill, Carol E. Achtmeyer, Kinsey A. McCormick, Katharine A. Bradley
The Annals of Family Medicine May 2006, 4 (3) 213-220; DOI: 10.1370/afm.542
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