Alcohol-related discussions in primary care: a report from ASPN. Ambulatory Sentinel Practice Network

J Fam Pract. 2000 Jan;49(1):28-33.


Background: Problem drinking is common, and a 15-minute intervention can help some patients reduce drinking to safe levels. Little is known, however, about the frequency and duration of alcohol-related discussions in primary care.

Methods: Nineteen clinicians in the Ambulatory Sentinel Practice Network (ASPN) collected data about alcohol-related discussions for 1 week following their usual office routine (Phase 1) and for 1 week with the addition of routine screening for problem drinking (Phase 2). Of those, 15 clinicians collected data for a third week after receiving training in brief interventions with problem drinkers (Phase 3). Clinicians collected data on standard ASPN reporting cards.

Results: In Phase 1 the clinicians discussed alcohol during 9.6% of all visits. Seventy-three percent of those discussions were shorter than 2 minutes long, and only 10% lasted longer than 4 minutes. When routine screening was added (Phase 2), clinicians were more likely to discuss alcohol at acute-illness visits, but the frequency, duration, and intensity of such discussions did not change. Only 32% of Phase 2 discussions prompted by a positive screening result lasted longer than 2 minutes. After training, the duration increased (P <.004). In Phase 3, 58% of discussions prompted by a positive screening result lasted longer than 2 minutes, but only 26% lasted longer than 4 minutes.

Conclusion: Routine screening changed the kinds of visits during which clinicians discussed alcohol use. Training in brief-intervention techniques significantly increased the duration of alcohol-related discussions, but most discussions prompted by a positive screening result were still shorter than effective interventions reported in the literature.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol Drinking / prevention & control*
  • Canada
  • Family Practice / education*
  • Family Practice / methods
  • Family Practice / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Mass Screening / methods
  • Mass Screening / statistics & numerical data
  • Nurse Practitioners / education*
  • Nurse Practitioners / statistics & numerical data*
  • Patient Education as Topic / methods
  • Patient Education as Topic / statistics & numerical data
  • Physician Assistants / education*
  • Physician Assistants / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care / methods
  • Primary Health Care / statistics & numerical data*
  • United States