Differences in brief interventions on excessive drinking and smoking by primary care physicians: qualitative study

Aira, Marja; Kauhanen, Jussi; Larivaara, Pekka; Rautio, Pertti

doi:10.1016/j.ypmed.2003.11.023

Cited by 35 publications

(51 citation statements)

References 16 publications

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“…Furthermore, qualitative work on alcohol screening in the primary care setting in Finland by Aira et al identified that physicians were more comfortable in undertaking a preventive approach for smoking than for alcohol use. 70 Factors contributing to this difference were difficulties in recognition and determination of the health risk by physicians, lack of effective tools, and lack of positive feedback after interventions. These must also be considered with any attempts to improve implementation of secondary prevention of alcohol misuse.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Accuracy of one or two simple questions to identify alcohol-use disorder in primary care: a meta-analysis

et al. 2014

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BackgroundThere is much interest in ultra-short alcohol screening in primary care that may support brief alcohol interventions. Brief screening consisting of one or two questions might be used alone or in combination with longer tests as recommended by the Primary Care Service Framework. AimTo investigate whether a simple one and two question screening might prove an accurate and acceptable screening method in primary care. Design and settingA systematic literature search, critical appraisal and meta-analysis were conducted. MethodA comprehensive search identified 61 analyses of single questions to detect alcohol problems including 17 that took place in primary care, using a robust interview standard. Despite focusing alcohol-use disorder in primary care settings, heterogeneity remained high, therefore random effects and bivariate meta-analyses were used. ResultsAfter adjustments, diagnostic accuracy of a single-question approach was given by a sensitivity of 54.5% (95% CI = 43.0% to 65.5%) and a specificity of 87.3% (95% CI = 81.5% to 91.5%) using meta-analytic weighting. Two questions had a sensitivity of 87.2% (95% CI = 69.9% to 97.7%) and specificity of 79.8% (95% CI = 75.7% to 83.6%). Looking at each question individually, the most successful single question was a modification of the Single Alcohol Screening Question (SASQ) namely, 'How often do you have six or more drinks on one occasion?'. The optimal approach appears to be two questions followed by the CAGE questionnaire, which achieved an overall accuracy of 90.9% and required only 3.3 questions per attendee. ConclusionTwo brief questions can be used as an initial screen for alcohol problems but only when combined with a second-step screen. A brief alcohol intervention should be considered in those individuals who answer positively on both steps. Keywordsalcohol; diagnostic accuracy; diagnostic validity; primary care; sensitivity; specificity.

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Section: Comparison With Existing Literaturementioning

confidence: 99%

Accuracy of one or two simple questions to identify alcohol-use disorder in primary care: a meta-analysis

et al. 2014

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“…Of the original publications identified using the search techniques, five were excluded because they contained no patient outcomes [12][13][14][15][16], two were excluded because they were qualitative studies [17,18], seven were excluded because the sample was too old [19][20][21][22][23][24][25], eight were not clinical interventions [7,[26][27][28][29][30][31][32], and three studies did not include the physician as an interventionist [29,33,34]. The search resulted in ten publications that met the search criteria.…”

Section: Methodsmentioning

confidence: 99%

“…In another national survey, pediatricians reported screening significantly more [15][16][17] year olds (Mean=76.8%) than 11-14 year olds (Mean= 53.0%) [7].…”

Section: Introductionmentioning

confidence: 96%

Review of Clinical Trials Testing the Effectiveness of Physician Approaches to Improving Alcohol Education and Counseling in Adolescent Outpatients

Boekeloo¹,

Griffin²

2007

CPR

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Trials indicate that further reduction in adolescent alcohol use is possible with non-physicians as interventionists and perhaps physicians as interventionists, if physicians are supported by patient counseling guides and resources. Opportunities for personalized, interactive adolescent education with goal setting appears key to intervention success. The physician role that is tested in most trials is confined to a single brief encounter with little attention to: development of physician skills, systems-level resources, the parental role, or the impact of incorporating prevention into an ongoing adolescent-physician relationship.

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“…In addition to these discrepancies, another study showed that physicians may be more willing to discuss the use of other substances, e.g. tobacco, rather than the use of alcohol (Aira, Kauhanen, Larivaara, & Rautio, 2004).…”

Section: What Are the Barriers To Sbi For Problem Alcohol Use In Primmentioning

confidence: 99%

Commentary on ‘The research translation problem: Alcohol screening and brief intervention in primary care – Real world evidence supports theory’

Klimas

Field

Barry

et al. 2011

Drugs: Education, Prevention and Policy

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Differences in brief interventions on excessive drinking and smoking by primary care physicians: qualitative study

Cited by 35 publications

References 16 publications

Accuracy of one or two simple questions to identify alcohol-use disorder in primary care: a meta-analysis

Accuracy of one or two simple questions to identify alcohol-use disorder in primary care: a meta-analysis

Review of Clinical Trials Testing the Effectiveness of Physician Approaches to Improving Alcohol Education and Counseling in Adolescent Outpatients

Commentary on ‘The research translation problem: Alcohol screening and brief intervention in primary care – Real world evidence supports theory’

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