Screening for alcoholism by life-style risk assessment in a community hospital

Article Abstract:

Although alcoholism and hazardous drinking behavior contribute significantly to the reasons patients need hospitalization, hospitals rarely develop screening procedures to identify and treat patients with drinking problems. The effects of a newly developed system to identify alcohol-related problems (life-style risk assessment) among patients admitted to a community hospital were evaluated. The system relied upon a voluntarily completed questionnaire that could be administered by a nurse in under 20 minutes; the questionnaire used three standard screening tests. One hundred consecutive patients newly admitted to the medical-surgical unit took part. Nineteen of the 21 patients identified as alcoholics by one screening test (the MAST) had alcoholism or alcohol abuse listed as a discharge diagnosis; this is equivalent to a 90 percent correct identification rate using the screening procedure. The screening procedure apparently helped physicians to identify those patients with alcohol problems. In another group of 100 patients hospitalized six months later who were not screened with the special protocol, only 12 had alcoholism or alcohol abuse listed as a discharge diagnosis. Based on the assumed frequency of these problems in such a group, the frequency of correct identification was only 57 percent. The proportions of patients for whom plans concerning alcohol-related problems appeared in discharge summaries, and who received referrals for alcoholism treatment programs, were greater in the group of patients who underwent assessment. Nurses spent 35 hours screening patients with the questionnaire, and approximately six hours of physician time were needed for discussions with nurses and interpretation of the interviews. In general, physicians and patients were satisfied with the life-style risk assessment program. The program was inexpensive, costing about as much as a urinalysis ($10). It was an effective approach to identifying patients with problems related to excess alcohol consumption. (Consumer Summary produced by Reliance Medical Information, Inc.)

Life style, Lifestyles

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Alcohol abuse in patients with dilated cardiomyopathy: laboratory vs clinical detection

Article Abstract:

As many as 40 to 50 percent of patients with congestive cardiomyopathy (disease of the heart muscle) may have alcoholic cardiomyopathy (caused by excessive alcohol intake). Despite the seriousness of the problem, little is known about the condition, and it is often undiagnosed, primarily because of the difficulties in obtaining honest and adequate reports on alcohol abuse from the patient. There is evidence that alcoholic cardiomyopathy is highly reversible if the patient stops drinking, making the identification of those patients with heart problems who may be suffering from alcohol cardiomyopathy important. In a study of 31 patients with dilated cardiomyopathy, 18 patients were assigned to the non-alcoholic group because their condition was definitively attributed to another cause, such as long-standing poorly controlled high blood pressure. Thirteen patients were assigned to the alcoholic group based on a history of drinking obtained from family members and the absence of any other apparent cause contributing to the heart condition. The two groups were then compared on the basis of clinical data and laboratory test results. It was found that there were no differences between the groups based on the self-reports of drinking. The Alcohol Clinical Index is a composite score of several signs thought to be indicative of alcohol abuse. None of the patients in the alcoholic group, and only one of the patients in the non-alcoholic group, reached the cutoff point for alcohol abuse as defined in the Index. However, it was found that mean volume of the red blood cells and the serum levels of gamma-glutamyltranspeptidase (GGTP) were elevated in the patients in the alcoholic group. The use of clinical signs for diagnosing alcohol abuse among cardiac patients may be inferior to using laboratory values for diagnosis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Causes of, Alcohol, Ethanol, Cardiac patients, Cardiomyopathy, Dilated, Congestive cardiomyopathy, Alcohol use

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A New Brief Screen for Adolescent Substance Abuse

Article Abstract:

A nine-item brief screening test for substance abuse accurately identifies teenagers who may require drug and alcohol abuse treatment. Researchers administered the brief test, plus the standard Personal Involvement with Chemicals Scale (PICS) to 99 teenagers. The brief screen classified 86% of the teenagers appropriately, using the PICS results as the standard. The CRAFFT brief screen questions teenagers about desires to cut down on drinking, drinking to relax, family and friends' drinking habits, and trouble resulting from alcohol use.

United States, Teenagers, Youth, Drug use, Psychological tests for children, Childhood psychological tests

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