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2014, Number s1

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Gac Med Mex 2014; 150 (s1)

Discriminative capacity of a simple question as a screening for hazardous and harmful alcohol consumption in a university medical service

Becerra MN, Laverde FG, Vivas PJM

Language: Spanish
References: 57
Page: 21-28
PDF size: 230.13 Kb.


ABSTRACT

Introduction: Alcohol misuse has been recognized as a public health problem in universities. It is possible to achieve a preventive approach if early identification of people with risky and harmful drinking patterns is achieved. There are multiple screening instruments with acceptable sensitivity. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has recommended the use of a simple question to screen hazardous and harmful alcohol consumption in primary care and their incorporation into routine clinical practice. Objective: To determine the discriminative ability of a simple question as a screening in a student health service. Methods: We applied this question to 303 patients treated at a university medical service, followed by the AUDIT. Results: Using AUDIT as a reference, the sensitivity and specificity of the simple question to detect hazardous and harmful alcohol consumption was 0.90 (95% CI: 0.68-0.98) and 0.76 (95% CI: 0.70-0.80), respectively, with a negative predictive value of 99.1%. Conclusions: The simple question can timely detect people with risky and harmful alcohol consumption in a university medical service. This requires implementing a systematic approach to timely identify and intervene in this problem.


REFERENCES

  1. Anderson P, Gual A, Colon J. Alcohol y atención primaria de la salud: informaciones clínicas básicas para la identificación y el manejo de riesgos y problemas. Washington, D.C.: Organización Panamericana de la Salud; 2008.

  2. Jonas DE, Garbutt JC, Brown JM, et al. Screening, Behavioral Counseling, and Referral in Primary Care To Reduce Alcohol Misuse [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2012 Jul. (Comparative Effectiveness Reviews, N.º 64.). Disponible en: http://www. ncbi.nlm.nih.gov/books/NBK99199/.

  3. World Health Organization. The Global status report on alcohol and health. Ginebra, Suiza; 2011.

  4. Organización Panamericana de la Salud. Alcohol y salud pública en las Américas: un caso para la acción. Washington, D.C.: OPS; 2007.

  5. Rehm J, Monteiro M. Alcohol consumption and burden of disease in the Americas: implications for alcohol policy. Rev Panam Salud Publica. 2005;18(4-5):241-8.

  6. Flórez, L. Diagnóstico e intervención del consumo excesivo de alcohol en ambientes educativos. TIPICA: Boletín Electrónico de Salud Escolar. 2007;3(2).

  7. Salazar I, Varela M, Cáceres D, Tovar J. El consumo de alcohol y tabaco en jóvenes colombianos: factores psicosociales de riesgo y protección. Psicología Conductual. 2006;14(1):77-101.

  8. Karam E, Kypri K, Salamoun M. Alcohol use among college students: an international perspective. Curr Opin Psychiatry. 2007;20:213-21.

  9. Pedrelli P, Bentley K, Vitali M, et al. Compulsive use of alcohol among college students. Psychiatry Research. 2013;205(1-2):95-102.

  10. Fergusson DM, Boden JM, Horwood LJ. Alcohol misuse and psychosocial outcomes in young adulthood: Results from a longitudinal birth cohort studied to age 30. Drug Alcohol Depend. (2013). Disponible en: http:// dx.doi.org/10.1016/j.drugalcdep.2013.07.015.

  11. Ronald D. US Department of Health and Human Services. Healthy People 2010. Washington; 2000. p. 26-9.

  12. National Institute on Alcohol Abuse and Alcoholism. National Advisory Council on Alcohol Abuse and Alcoholism. Task Force on College Drinking. High-Risk Drinking in College: What We Know and What We Need To Learn. Final Report of the Panel on Contexts and Consequences. U.S. Department of Health and Human Services. 2002.

  13. Johnston LD, O’Malley PM, Bachman JG. Monitoring the future national survey results on drug use, 1975-2002, volume II: College students and adults ages 19-40. Bethesda: National Institute on Drug Abuse; 2003.

  14. Slutske WS, Hunt-Carter EE, Nabors-Oberg RE. Do college students drink more than their non-college-attending peers? Evidence from a population- based longitudinal female twin study. J Abnorm Psycho. 2004;113(4):530-40.

  15. Ham LS, Hope DA. College students and problematic drinking: a review of the literature. Clin Psychol Rev. 2003;23(5):719-59.

  16. Díaz Martínez A, Díaz Martínez LR, Hernández-Ávila CA, et al. Prevalencia del consumo riesgoso y dañino de alcohol y factores de riesgo en estudiantes universitarios de primer ingreso. Salud Mental. 2008;31:271-82.

  17. Comisión Interamericana para el Control del Abuso de Drogas CICAD/ Organización de los Estados Americanos OEA. II Estudio Epidemiológico Andino sobre Consumo de Drogas en la Población Universitaria. Informe Regional. Comunidad Andina. 2012.

  18. Pardo C, Piñeros M. Consumo de alcohol y conductas de riesgo asociadas en escolares colombianos. Rev Colomb Cancerol. 2012;16(4): 217-26.

  19. López-de-Munain J, Torcal J, López V, Garay J. Prevention in routine general practice: activity patterns and potential promoting factors. Prev Med. 2001;32(1):13-22.

  20. Kaner E, Heather N, McAvoy B, et al. Intervention for excessive alcohol consumption in primary health care: attitudes and practices of English general practitioners. Alcohol Alcohol. 1999;34(4):559-66.

  21. Rumpf HJ, Bohlmann J, Hill A, et al. Physicians’ low detection rates of alcohol dependence or abuse: a matter of methodological shortcomings? Gen Hosp Psychiatry. 2001;23(3):133-7.

  22. Aalto M, Pekuri P, Seppa K. Primary health care professionals’ activity in intervening in patients’ alcohol drinking: a patient perspective. Drug Alcohol Depend. 2002;66(1):39-43.

  23. Friedmann PD, McCullough D, Chin MH, et al. Screening and intervention for alcohol problems. A national survey of primary care physicians and psychiatrists. J Gen Intern Med. 2000;15(2):84-91.

  24. Dawson DA, Grant BF, Stinson FS, et al. Recovery from DSM-IV alcohol dependence: United States, 2001-2002. Addiction. 2005;100(3):281-92.

  25. Hasin DS, Stinson FS, Ogburn E, Grant BF. Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Arch Gen Psychiatry. 2007;64(7): 830-42.

  26. Aalto M, Pekuri P, Seppa K. Primary health care professionals’ activity in intervening in patients’ alcohol drinking during a 3-year brief intervention implementation project. Drug Alcohol Depend. 2003;69(9):9-14.

  27. Bradley KA, Epler AJ, Bush KR, et al. Alcohol-related discussions during general medicine appointments of male VA patients who screen positive for at-risk drinking. J Gen Intern Med. 2002;17(5):315-26.

  28. Babor T, Higgins-Biddle J, Saunders J, Monteiro M. AUDIT. Cuestionario de Identificación de los Trastornos debidos al Consumo de Alcohol. Pautas para su utilización en Atención Primaria. Organización Mundial de la Salud. Departamento de Salud Mental y Dependencia de Sustancias. Ginebra, Suiza; 2001.

  29. Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. TheAUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test Arch Intern Med. 1998;158(16):1789-95.

  30. U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism. Helping patients who drink too much: a clinician’s guide. Bethesda, Md.: National Institute on Alcohol Abuse and Alcoholism; 2007. NIH publication no. 07-3769. Disponible en: http://pubs.niaaa.nih.gov/publications/ Practitioner/CliniciansGuide2005/guide.pdf. Consultado el 27 de junio de 2013. Gaceta Médica de México. 2014;150 Suppl 1 28

  31. Saunders JB, Aasland OG, Babor TF, De la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II. Addiction. 1993;88(6):791-804.

  32. Gordon AJ, Maisto SA, McNeil M, et al. Three questions can detect hazardous drinkers. J Fam Pract. 2001;50(4):313-20.

  33. Willenbring ML, Massey SH, Gardner MB. Helping patients who drink too much: an evidence-based guide for primary care physicians. Am Fam Physician. 2009;80(1):44-50.

  34. Friedmann P. Alcohol use in adults. N Engl J Med. 2013;368:4.

  35. Becerra N, Alba LH, Granados MC. Orientaciones para la implementación de un programa de mantenimiento de la salud en los servicios de salud universitarios. Aportes desde la experiencia de la Pontificia Universidad Javeriana Bogotá, Colombia. Universitas Médica. 2013;54(3).

  36. Ospina JM, Manrique FG, Ariza NE. Confiabilidad y dimensionalidad del Cuestionario para Identificación de Trastornos Debidos al Consumo de Alcohol (AUDIT) en estudiantes universitarios de Tunja (Colombia). Salud Uninorte. 2012;28(2):276-82.

  37. Rosón B. Consumo de riesgo y perjudicial de alcohol. Prevalencia y métodos de detección en la práctica clínica. Galicia Clin. 2008;69(1):29-44.

  38. Kaner EF, Beyer F, Dickinson HO, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2007;(2):CD004148.

  39. Kaner, E, Bland M, Cassidy P, et al. Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial. BMJ. 2013;346:e8501.

  40. Jonas DE, Garbutt JC, Amick HR, et al. Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2012;157(9):645-54.

  41. U.S. Preventive Services Task Force. Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse: Clinical Summary. AHRQ Publication No. 12-05171-EF-4. Current as of May 2013. Disponible en: http://www.uspreventiveservicestaskforce.org/alcmisusesum.htm.

  42. Rubio G, Jiménez-Arriero MA, Martínez I, et al. Efficacy of physician-delivered brief counseling intervention for binge drinkers. Am J Med. 2010;123(1):72-8.

  43. American Society of Addiction Medicine. Public Policy Statement on Screening for Addiction in Primary Care Settings. Chevy Chase, MD: American Society of Addiction Medicine; 1997. Disponible en: www. asam.org/advocacy/find-a-policy- statement/view-policy-statement/publicpolicy- statements/2011/12/16/screening-for- addiction-in-primary- care-settings. Consultado el 12 de marzo de 2012.

  44. Fleming MF, Graham AW. Screening and brief interventions for alcohol use disorders in managed care settings. Recent Dev Alcohol. 2001; 15:393-416.

  45. Bolaños Gallardo E. Estudio sobre las percepciones, creencias y actitudes de los y las profesionales de atención primaria respecto al consumo de alcohol y su abordaje desde el sistema de salud. Proyecto POCTEP 2009-2010 de colaboración transfronteriza con la Zona Centro de Portugal y la Provincia de Salamanca. Junta de Castilla y León, España, 2010. Disponible en: http://www.jcyl.es/web/jcyl/binarios/74/862/ Percepciones%20y%20actitudes%20de%20los%20profesionales%20 de%20atenci%C3%B3n%20primaria%20sobre%20el%20alcohol.pdf. Consultado el 14 de julio de 2013.

  46. Dawson DA, Grant BF, Li TK. Quantifying the risks associated with exceeding recommended drinking limits. Alcohol Clin Exp Res. 2005;29(5):902-8.

  47. Dawson DA, Li TK, Grant BF. A prospective study of risk drinking: at risk for what? Drug Alcohol Depend. 2008;95(1-2):62-72.

  48. Medina MC. Generalidades de las pruebas diagnósticas, y su utilidad en la toma de decisiones médicas. Revista Colombiana de Psiquiatría. 2011;40(4):787-97.

  49. Stewart SH, Borg KT, Miller PM. Prevalence of problem drinking and characteristics of a single-question screen. J Emerg Med. 2010;39(3): 291-5.

  50. Smith PC, Schmidt SM, Allensworth-Davies D, et al. Primary care validation of a single-question alcohol screening test. J Gen Intern Med. 2009;24(7):783-8.

  51. Vinson D, Kruse R, Seale JP. Simplifying alcohol assessment: two questions to identify alcohol use disorders. Alcohol Clin Exp Res. 2007;31(8): 1392-8.

  52. Massey S, Norris L, Lausin M, Nwaneri C, Lieberman D. Identifying harmful drinking using a single screening question in a psychiatric consultation-liaison population. Psychosomatics. 2011:52(4):362-6.

  53. Browne A, Newton M, Gope, Schug SA, Wood FM, Allsop S. Screening for harmful alcohol use in Australian trauma settings. Int J Care Injured. 2013;44(1):110-7.

  54. Jonas D, Garbutt J, Amick H, et al. Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta- analysis for the U.S. Preventive Services Task Force. Ann Intern Med. 2012;157(9):645.

  55. Pengpi S, Peltzer K, Van der Heever H, Skaal L. Screening and brief interventions for hazardous and harmful alcohol use among university students in South Africa: results from a randomized controlled trial. Int J Environ Res Public Health. 2013;10(5):2043-57.

  56. Anderson P, Gual A, Colon J. Alcohol y atención primaria de la salud: informaciones clínicas básicas para la identificación y el manejo de riesgos y problemas. Organización Panamericana de la Salud. 2008.

  57. Agency for Healthcare Research and Quality U.S. Department of Health and Human Services . Screening, Behavioral Counseling, and Referral in Primary Care to Reduce Alcohol Misuse. July 2012.




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