Background
Some primary care physicians do not conduct alcohol screening because they assume their patients do not want to discuss alcohol
use.
Objectives
To assess whether (1) alcohol counseling can improve patient-perceived quality of primary care, and (2) higher quality of
primary care is associated with subsequent decreased alcohol consumption.
Design
A prospective cohort study.
Subjects
Two hundred eighty-eight patients in an academic primary care practice who had unhealthy alcohol use.
Measurements
The primary outcome was quality of care received [measured with the communication, whole-person knowledge, and trust scales
of the Primary Care Assessment Survey (PCAS)]. The secondary outcome was drinking risky amounts in the past 30 days (measured
with the Timeline Followback method).
Results
Alcohol counseling was significantly associated with higher quality of primary care in the areas of communication (adjusted
mean PCAS scale scores: 85 vs. 76) and whole-person knowledge (67 vs. 59). The quality of primary care was not associated
with drinking risky amounts 6 months later.
Conclusions
Although quality of primary care may not necessarily affect drinking, brief counseling for unhealthy alcohol use may enhance
the quality of primary care.
KEY WORDS alcohol - counseling - brief intervention - quality of primary care
Results of this study were presented at the following meetings: the annual national meeting of the Society of General Internal
Medicine, Chicago, May 2004 and the annual national meeting of the Research Society on Alcoholism, Vancouver, Canada, June
2004. This study was funded by a grant from the Robert Wood Johnson Foundation (grant 031489). Dr. Samet received support
from the National Institute on Alcohol Abuse and Alcoholism (K24-AA015674).