Brief Report

Journal of General Internal Medicine

, Volume 23, Issue 9, pp 1482-1486

Alcohol Counseling Reflects Higher Quality of Primary Care

  • Richard SaitzAffiliated withClinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center and Boston University School of MedicineYouth Alcohol Prevention Center, Boston University School of Public HealthDepartment of Epidemiology, Boston University School of Public Health Email author 
  • , Nicholas J. HortonAffiliated withDepartment of Mathematics and Statistics, Smith College
  • , Debbie M. ChengAffiliated withClinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center and Boston University School of MedicineDepartment of Biostatistics, Boston University School of Public Health
  • , Jeffrey H. SametAffiliated withClinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center and Boston University School of MedicineDepartment of Social and Behavioral Sciences, Boston University School of Public Health

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Abstract

Background

Some primary care physicians do not conduct alcohol screening because they assume their patients do not want to discuss alcohol use.

Objectives

To assess whether (1) alcohol counseling can improve patient-perceived quality of primary care, and (2) higher quality of primary care is associated with subsequent decreased alcohol consumption.

Design

A prospective cohort study.

Subjects

Two hundred eighty-eight patients in an academic primary care practice who had unhealthy alcohol use.

Measurements

The primary outcome was quality of care received [measured with the communication, whole-person knowledge, and trust scales of the Primary Care Assessment Survey (PCAS)]. The secondary outcome was drinking risky amounts in the past 30 days (measured with the Timeline Followback method).

Results

Alcohol counseling was significantly associated with higher quality of primary care in the areas of communication (adjusted mean PCAS scale scores: 85 vs. 76) and whole-person knowledge (67 vs. 59). The quality of primary care was not associated with drinking risky amounts 6 months later.

Conclusions

Although quality of primary care may not necessarily affect drinking, brief counseling for unhealthy alcohol use may enhance the quality of primary care.

KEY WORDS

alcohol counseling brief intervention quality of primary care