Identification and characterization of older emergency department patients with high-risk alcohol use.

Autor: Shenvi CL; Department of Emergency Medicine University of North Carolina-Chapel Hill Chapel Hill North Carolina USA., Weaver MA; Department of Mathematics and Statistics Elon University Elon North Carolina USA., Biese KJ; Department of Emergency Medicine University of North Carolina-Chapel Hill Chapel Hill North Carolina USA., Wang Y; Wake Forest School of Medicine Winston Salem North Carolina USA., Revankar R; Mt. Sinai Icahn School of Medicine New York City New York USA., Fatade Y; Department of Internal Medicine Emory University Atlanta Georgia USA., Aylward A; Department of Emergency Medicine University of North Carolina-Chapel Hill Chapel Hill North Carolina USA., Busby-Whitehead J; Division of Geriatrics University of North Carolina-Chapel Hill Chapel Hill North Carolina USA., Platts-Mills TF; Department of Emergency Medicine University of North Carolina-Chapel Hill Chapel Hill North Carolina USA., D'Onofrio G; Department of Emergency Medicine Yale School of Medicine New Haven Connecticut USA.
Jazyk: angličtina
Zdroj: Journal of the American College of Emergency Physicians open [J Am Coll Emerg Physicians Open] 2020 Jul 17; Vol. 1 (5), pp. 804-811. Date of Electronic Publication: 2020 Jul 17 (Print Publication: 2020).
DOI: 10.1002/emp2.12196
Abstrakt: Background: High-risk alcohol use in the elderly is a common but underrecognized problem. We tested a brief screening instrument to identify high-risk individuals.
Methods: This was a prospective, cross-sectional study conducted at a single emergency department. High-risk alcohol use was defined by National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines as >7 drinks/week or >3 drinks/occasion. We assessed alcohol use in patients aged ≥ 65 years using the timeline follow back (TLFB) method as a reference standard and a new, 2-question screener based on NIAAA guidelines. The Alcohol Use Disorders Identification Test (AUDIT) and Cut down, Annoyed, Guilty, Eye-opener (CAGE) screens were used for comparison. We collected demographic information from a convenience sample of high- and low-risk drinkers.
Results: We screened 2250 older adults and 180 (8%) met criteria for high-risk use. Ninety-eight high-risk and 124 low-risk individuals were enrolled. The 2-question screener had sensitivity of 98% (95% CI, 93%-100%) and specificity of 87% (95% CI, 80%-92%) using TLFB as the reference. It had higher sensitivity than the AUDIT or CAGE tools. The high-risk group was predominantly male (65% vs 35%, P < 0.001). They drank a median of 14 drinks per week across all ages from 65 to 92. They had higher rates of prior substance use treatment (17% vs 2%, P < 0.001) and current tobacco use (24% vs 9%, P = 0.004).
Conclusion: A rapid, 2-question screener can identify high-risk drinkers with higher sensitivity than AUDIT or CAGE screening. It could be used in concert with more specific questionnaires to guide treatment.
Competing Interests: None of the authors has any conflict of interest for this research.
(© 2020 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of the American College of Emergency Physicians.)
Databáze: MEDLINE
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