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141 Alcoholism screening and counselling in trauma patients seen at physician offices in the united states (us)
  1. Junaid Bhatti1,
  2. A Donald2
  1. 1CA Sunnybrook Research Institute
  2. 2CA Redelmeier


Purpose Trauma leads to one in ten physician office visits in the US. Alcohol is a significant predictor of these injuries. We assessed whether the rates of alcoholism screening and counselling were higher in trauma patients as compared to non-trauma patients in US physician offices.

Methods Study data were extracted from the National Ambulatory Care Survey (NAMCS). NAMCS’s, a nationwide, cross-sectional sample of physician office visits in the US. We focused on NAMCS data from 2014 as it included information on alcoholism screening and counselling. Patients were distinguished as trauma and non-trauma patients by a specific field. We estimated weighted frequencies using software SAS version 9.4.

Findings Of 45 523 patient visits, 5455 (11.6%) were related to traumatic injuries. A total of 187 patients (0.6%) received alcoholism screening and 178 (0.5%) received alcoholism counselling. About 413 (1.0%) patients in NAMCS 2014 survey were identified as those with ongoing alcohol misuse problems. In this subgroup, the rates of alcoholism screening were 11.7% (n=34) and alcoholism counselling was 21.2% (n=76). In overall sample, a trauma-related patient-visit doubled the odds of alcoholism screening (13.4/1,000 visits, 95% Confidence Intervals [CI]=9.8–16.6) than a non-trauma patient-visit (5.6/1,000 visits, 95%CI=3.6’“7.5). Similarly, a trauma-related patient-visit doubled the odds of alcoholism counselling (13.5/1,000 visits, 95%CI=10.5–16.3) than a non-trauma visit (3.8/1,000 visits, 95%CI=2.5’“5.1). In the alcohol misuse subgroup, the trauma-related patient-visits led to alcoholism screening three times more often than a non-trauma patient-visits (16.9% vs. 6.1%). In the same patients, a trauma patient-visit led to alcoholism counselling twice as often than a non-trauma patient-visit (27.6% vs. 14.2%).

Conclusion Trauma-related physician office visits were more likely to result in alcoholism screening and counselling than other visits.

Significance There is still large room for improvements in alcoholism screening and counselling in physician offices to match recommendations from the Institute of Medicine.

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