20 Nov Primary Care Providers Should Ask All Adults About Alcohol Use
MedicalResearch.com Interview with:
Dr. Carol Mangione M.D., M.S.P.H., F.A.C.P
Ronald Reagan UCLA Medical Center
Division Chief of General Internal Medicine and Health Services Research
Professor of Medicine.
Barbara A. Levey, MD, and Gerald S. Levey, MD
Endowed chair in medicine David Geffen School of Medicine
University of California
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Unhealthy alcohol use is relatively common and is increasing among U.S. adults. Alcohol use is the third leading cause of preventable death in the U.S. and contributes to more than 88,000 deaths per year. In pregnancy, it also leads to birth defects and developmental problems in children. The Task Force found that screening tests and brief counseling interventions can help detect and reduce unhealthy alcohol use among adults, and in turn help prevent negative consequences related to alcohol use. For adolescents ages 12 to 17, clinicians should use their best judgment when deciding whether or not to screen and refer their patients to counseling, until we have better studies available.
MedicalResearch.com: What should readers take away from your report?
Response: Primary care providers should ask all adults, including pregnant women, about their drinking habits and offer brief counseling to those who drink unhealthy amounts of alcohol. There are a number of brief established screening questionnaires that can be used for this purpose. Asking even a single question can be effective at detecting unhealthy alcohol use. There are also well-tested approaches for how to counsel people about reducing unhealthy alcohol use – these usually include a discussion of how a patient’s drinking patterns compare to the recommended limits and recommendations for how to reduce drinking.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: More research is needed about the benefits and risks of screening adolescents for alcohol use and providing effective counseling interventions. Among adults, we need more research on how screening and counseling interventions affect long-term outcomes, such as hospitalization, illness, injuries, and death, as well as about any harms related to screening and interventions.
MedicalResearch.com: Is there anything else you would like to add?
Response: Despite the recent national focus on underage drinking, there was unfortunately not enough research available for us to recommend for or against screening and brief counseling interventions for alcohol use in teens who are 12 to 17 years old. This lack of evidence is a serious problem, and we are calling for more research so that we can give better guidance to clinicians on their role in preventing and mitigating the negative consequences of alcohol use in adolescents.
US Preventive Services Task Force. Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and AdultsUS Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(18):1899–1909. doi:10.1001/jama.2018.16789
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