An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking
Abstract Background Although alcohol use disorder can complicate depression management, there is no standard process for assessing AUD symptoms (i.e., AUD diagnostic criteria) in primary care for patients who screen positive for depression. This study characterizes the association between depressive...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-022-08408-1 |
| _version_ | 1798003013317558272 |
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| author | Emma D. Ryan Yanni M. Chang Malia Oliver Katharine A. Bradley Kevin A. Hallgren |
| author_facet | Emma D. Ryan Yanni M. Chang Malia Oliver Katharine A. Bradley Kevin A. Hallgren |
| author_sort | Emma D. Ryan |
| collection | DOAJ |
| description | Abstract Background Although alcohol use disorder can complicate depression management, there is no standard process for assessing AUD symptoms (i.e., AUD diagnostic criteria) in primary care for patients who screen positive for depression. This study characterizes the association between depressive symptoms and high-risk drinking reported by primary care patients on screening measures in routine care. Then, using data from a novel clinical program, this study characterizes the association between depressive symptoms and AUD symptoms reported by primary care patients with high-risk drinking via an Alcohol Symptom Checklist. Methods In this cross-sectional study, electronic health record data were obtained from patients who visited 33 Kaiser Permanente Washington primary care clinics between 03/2018 and 02/2020 and completed depression (PHQ-2) and alcohol consumption (AUDIT-C) screening measures as part of routine care (N = 369,943). Patients who reported high-risk drinking (AUDIT-C scores 7–12) also completed an Alcohol Symptom Checklist where they reported the presence or absence of 11 AUD criteria as defined by the DSM-5 (N = 8,184). Generalized linear models estimated and compared the prevalence of high-risk drinking (AUDIT-C scores 7–12) and probable AUD (2–11 AUD symptoms on Alcohol Symptom Checklists) for patients with and without positive depression screens. Results Patients who screened positive for depression had a 131% higher prevalence of high-risk drinking than those who screened negative (5.2% vs. 2.2%; p < 0.001). Among patients with high-risk drinking, positive depression screens were associated with a significantly higher prevalence of probable AUD (69.8% vs. 48.0%; p < 0.001), with large differences in the prevalence of probable AUD observed with increasing PHQ-2 scores (e.g., probable AUD prevalence of 37.6%, 55.3% and 65.2%, for PHQ-2 scores of 0, 1, and 2, respectively). Although the overall prevalence of high-risk drinking was higher for male patients, similar patterns of association between depression screens, high-risk drinking, and AUD symptoms were observed for male and female patients. Conclusions Patients with positive depression screens are more likely to have high-risk drinking. Large percentages of patients with positive depression screens and high-risk drinking report symptoms consistent with AUD to healthcare providers when given the opportunity to do so using an Alcohol Symptom Checklist. |
| first_indexed | 2024-04-11T12:01:20Z |
| format | Article |
| id | doaj.art-ee9e1307f209428ba60e3407ea1b6eef |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-11T12:01:20Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-ee9e1307f209428ba60e3407ea1b6eef2022-12-22T04:24:51ZengBMCBMC Health Services Research1472-69632022-09-0122111110.1186/s12913-022-08408-1An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinkingEmma D. Ryan0Yanni M. Chang1Malia Oliver2Katharine A. Bradley3Kevin A. Hallgren4University of Washington School of MedicineDepartment of Psychiatry and Behavioral Sciences, University of WashingtonKaiser Permanente Washington Health Research InstituteKaiser Permanente Washington Health Research InstituteDepartment of Psychiatry and Behavioral Sciences, University of WashingtonAbstract Background Although alcohol use disorder can complicate depression management, there is no standard process for assessing AUD symptoms (i.e., AUD diagnostic criteria) in primary care for patients who screen positive for depression. This study characterizes the association between depressive symptoms and high-risk drinking reported by primary care patients on screening measures in routine care. Then, using data from a novel clinical program, this study characterizes the association between depressive symptoms and AUD symptoms reported by primary care patients with high-risk drinking via an Alcohol Symptom Checklist. Methods In this cross-sectional study, electronic health record data were obtained from patients who visited 33 Kaiser Permanente Washington primary care clinics between 03/2018 and 02/2020 and completed depression (PHQ-2) and alcohol consumption (AUDIT-C) screening measures as part of routine care (N = 369,943). Patients who reported high-risk drinking (AUDIT-C scores 7–12) also completed an Alcohol Symptom Checklist where they reported the presence or absence of 11 AUD criteria as defined by the DSM-5 (N = 8,184). Generalized linear models estimated and compared the prevalence of high-risk drinking (AUDIT-C scores 7–12) and probable AUD (2–11 AUD symptoms on Alcohol Symptom Checklists) for patients with and without positive depression screens. Results Patients who screened positive for depression had a 131% higher prevalence of high-risk drinking than those who screened negative (5.2% vs. 2.2%; p < 0.001). Among patients with high-risk drinking, positive depression screens were associated with a significantly higher prevalence of probable AUD (69.8% vs. 48.0%; p < 0.001), with large differences in the prevalence of probable AUD observed with increasing PHQ-2 scores (e.g., probable AUD prevalence of 37.6%, 55.3% and 65.2%, for PHQ-2 scores of 0, 1, and 2, respectively). Although the overall prevalence of high-risk drinking was higher for male patients, similar patterns of association between depression screens, high-risk drinking, and AUD symptoms were observed for male and female patients. Conclusions Patients with positive depression screens are more likely to have high-risk drinking. Large percentages of patients with positive depression screens and high-risk drinking report symptoms consistent with AUD to healthcare providers when given the opportunity to do so using an Alcohol Symptom Checklist.https://doi.org/10.1186/s12913-022-08408-1Alcohol use disorderAlcohol screeningBrief interventionDepressionPopulation healthPrimary care |
| spellingShingle | Emma D. Ryan Yanni M. Chang Malia Oliver Katharine A. Bradley Kevin A. Hallgren An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking BMC Health Services Research Alcohol use disorder Alcohol screening Brief intervention Depression Population health Primary care |
| title | An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking |
| title_full | An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking |
| title_fullStr | An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking |
| title_full_unstemmed | An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking |
| title_short | An Alcohol Symptom Checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high-risk drinking |
| title_sort | alcohol symptom checklist identifies high rates of alcohol use disorder in primary care patients who screen positive for depression and high risk drinking |
| topic | Alcohol use disorder Alcohol screening Brief intervention Depression Population health Primary care |
| url | https://doi.org/10.1186/s12913-022-08408-1 |
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