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Correlates of Alcohol‐Related Discussions Between Older Adults and Their Physicians
Author(s) -
Duru O. Kenrik,
Xu Haiyong,
Tseng ChiHong,
Mirkin Michelle,
Ang Alfonso,
Tallen Louise,
Moore Alison A.,
Ettner Susan L.
Publication year - 2010
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2010.03176.x
Subject(s) - medicine , binge drinking , comorbidity , logistic regression , alcohol , odds , alcohol use disorder , odds ratio , geriatrics , specialty , injury prevention , poison control , psychiatry , environmental health , biochemistry , chemistry
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.