Citation

Duru OK, Xu H, Tseng CH, Mirkin M, Ang A, Tallen L, Moore AA, Ettner SL. J. Am. Geriatr. Soc. 2010; 58(12): 2369-2374.

Affiliation

Division of General Internal Medicine, Health Services Research, Department of Family Medicine, Division of Geriatrics, University of California at Los Angeles, Los Angeles, California; and School of Social Work, University of Southern California, Los Angeles, California.

Copyright

(Copyright © 2010, John Wiley and Sons)

DOI

10.1111/j.1532-5415.2010.03176.x

PMID

21087224

PMCID

PMC3058868

Abstract

OBJECTIVES: To identify predictors of alcohol-related patient-physician discussions. DESIGN: Cross-sectional study using baseline data from a randomized controlled trial. SETTING: Community-based group practice. PARTICIPANTS: Thirty-one physicians in Project Senior Health and Alcohol Risk Education and 3,305 of their patients aged 60 and older who use alcohol and completed a survey that included the Comorbidity Alcohol Risk Evaluation Tool (CARET). MEASUREMENTS: At study baseline, older adults were asked whether alcohol-related discussions with a physician had occurred in the prior year. This outcome was modeled using logistic regression models with physician random effects. Predictor variables included patient-level variables such as demographics and seven CARET-defined risk factors, specifically a medical or psychiatric comorbidity that alcohol might worsen, a potentially alcohol-related symptom, use of a medication that may interact negatively with alcohol, excessive quantity or frequency of alcohol use, binge drinking, concern from others about drinking, and drinking and driving. Physician-level predictors (age, sex, years since graduation, specialty) were also included. RESULTS: The probability of reporting alcohol-related discussions declined with patient age (e.g., odds ratio (OR)=0.40 for patients aged ≥80) and was significantly lower for Latinos (OR=0.38). Drinking and driving (OR=1.69) or concern from others (OR=6.04) were significantly associated with alcohol-related discussions; having comorbidities or using medications that may interact with alcohol were not. CONCLUSION: Although patient demographics, including age and ethnicity, are associated with the occurrence of alcohol-related discussions, clinical factors that may negatively interact with alcohol to increase risk are not. This suggests that physicians may not be attuned to the entire spectrum of alcohol-related risks for older adults.

Language: en