Drinking amongst medical patients: levels of risk and models of change

Abstract

Results are reported of a study in which 547 general hospital medical in-patients were screened, using a computer-administered questionnaire, for alcohol consumption, problems and concerns. Of males, 22.5% were classified as 'risk drinkers', of women 6.5%. Rates of risk were particularly high amongst younger male patients. It was concluded that certain screening questionnaire items were more useful than others in the general hospital context, and that standard questionnaires developed for other populations should not automatically be used in general hospitals. Comparisons with items relating to other health behaviours suggested that the medical profession, the general public and the patients themselves might be relatively insensitive to the risks associated with heavy drinking in comparison to those associated with smoking, weight and lack of exercise. Data from initial screening and from 75% of patients who were asked to repeat the questionnaire six months later, were used to test certain assumptions of a model of change based in part upon that of Prochaska & DiClemente (1986). Results suggested that processes of change were more complex than the model supposed.

Hospital Morbidity of Alcohol Use Disorders in the Center of France

“…The present study is the only one to have examined the prevalence of alcohol use disorders over such a large geographical area. The level of alcohol use disorders, which affected 22.5% of inpatients in acute services (Medicine, Surgery, Obstetrics and Gynecology and Psychiatry) in the Auvergne region, appears to be high compared with other French studies (Table 7) and compared with figures in the international literature (An- dreasson et al, 1988;Niles and McGrady, 1991;Orford et al, 1992). The enquiry into alcohol-related disorders by Centre de Recherche, d'Etude et de la Documentation en Economie de la SantC in 1991 to 1992 gave an average prevalence of 19% for the acute hospital services (Corn Ruelle, 1998;Com Ruelle and Dumesnil, 1997).…”

Longitudinal trends in hospital admissions with co-occurring alcohol/drug diagnoses, 1994–2002

“…sample sizes (b500 subjects; Baldwin et al, 1993;Lange & Schacter, 1989;Marik & Mohedin, 1996;Stein, 1994;Wallerstedt, Denison, Sandstrom, & Westin, 1995) and crosssectional data of short duration (from days to months; John, Rumpf, & Hapke, 1999;Lange & Schacter, 1989;Marik & Mohedin, 1996;Orford, Somers, Daniels, & Kirby, 1992;Taylor, Kilbane, Passmore, & Davies, 1986), limited mostly to alcohol consumption and not illicit drug use and usually derived from only one clinical department (medicine or psychiatry).…”

Davidson's dilemma

“…Much change may occur because people's circumstances change, or simply because of ageing (Winick's (1962) 'maturing out' hypothesis), or perhaps because a new factor enters the equation overriding those currently in play. We have recently found evidence consistent with the idea of much 'non-contemplative change' amongst moderately risky drinkers admitted to medical wards of a general hospital (Orford et al, 1992). I suspect the stages of change model will not last very long in its present form, but it will have served a number of invaluable purposes.…”