RT Journal Article
SR Electronic
T1 Screening for Unhealthy Alcohol Use among Virginia Primary Care Patients with Multiple Chronic Conditions
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 3956
DO 10.1370/afm.21.s1.3956
VO 21
IS Supplement 1
A1 Huffstetler, Alison
A1 Rockwell, Michelle
A1 Webel, Benjamin
A1 Villalobos, Gabriela
A1 Epling, John
A1 Krist, Alex
A1 Funk, Adam
A1 Sabo, Roy
YR 2023
UL http://www.annfammed.org/content/21/Supplement_1/3956.abstract
AB Context: The prevalence of multiple chronic conditions (MCC) – defined as having two or more chronic medical conditions - is increasing in the U.S. In spite of a greater typical number of primary care encounters, patients living with MCCs have been found less likely to receive up-to-date preventive healthcare services. The screening rate for unhealthy alcohol use among patients with MCCs is not well-established.Objective: To assess the rate of screening for unhealthy alcohol use in primary care patients with MCC.Study Design and Analysis: We performed a cross-sectional analysis of chart review data collected at baseline of a statewide initiative to improve screening for unhealthy alcohol use in primary care.Outcome Measures: We examined patients’ problem list diagnoses (ICD-10 codes); history of alcohol screening during the previous 24 months; if screening occurred, tool used (USPSTF-validated or not); and screening outcome. We tabulated total number of diagnoses and calculated Charlson Comorbidity Index (CCI) for each patient. A CCI of >2 was considered indicative of MCC. The National Institute for Alcohol Use and Alcoholism definition of risky alcohol use served as criteria for a positive alcohol screening. Chi-square tests were used to evaluate differences in screening incidence and outcome based on number of problem list diagnoses and CCI.Results: Of 3211 patients (51.7 + 15.5 years, 63.5% female) in this cohort, 2201 (69%) were screened for unhealthy alcohol use, 296 (9%) with a validated screening tool. The mean number of problem list diagnoses was 8.6 + 4.7, with 690 patients (21.5%) having 15 or more. A total of 641 (20.0%) were living with MCCs based on CCI >2. There was no difference in the likelihood of being screened for unhealthy alcohol use or on being screened with a validated screening tool based on number of problem list diagnoses or on CCI. Patients with 11-15 problem list diagnoses were significantly more likely to experience a positive screening for unhealthy alcohol use compared with those having 1-5 or 6-10 diagnoses, X2 = 9.03, p= .031).Conclusions: Although we observed inadequate alcohol screening, particularly using a validated tool, across our cohort, patients living with MCCs did not appear to be screened at a different rate from patients without MCCs. They did, however, demonstrate a greater incidence of unhealthy alcohol use, emphasizing the importance of improving alcohol screening rates for primary care patients.