Patient factors influencing variation in the use of preventive interventions for alcohol abuse by primary care physicians

Objective: To identify patient factors associated with primary care physicians asking about alcohol consumption, warning of harmful ethanol effects, and advising modification of alcohol use in their patients. Method: A cross-sectional design was used, with a probability sample of 1,333 adult family medicine patients, stratified by sex and racial/ethnic background, drawn from a university-based, family medicine clinic. Patients completed self-report screens for alcohol-related problems (including the CAGE) and questionnaires on their experiences with their primary care provider. Results: Over 64% of male and female patients indicated their physician had asked them at some time about their alcohol consumption. Logistic regression models indicated that male patients were 1.5 times as likely to have been warned about alcohol and three times as likely to have been told to stop or modify their consumption compared to female patients. Patients with lower educational attainment were more likely to have been warned, while the likelihood of ever being told to stop or modify consumption increased with age. These associations were significant after controlling for patient race/ethnicity, cigarette use and CAGE scores. Conclusions: Patient factors including sex, educational attainment, age, cigarette use and problem alcohol use appear to explain some of the variation in the use of preventive interventions for alcohol abuse by primary care providers. Yet, different patient factors appear to be related to the use of different preventive interventions. The role of patient factors, and in particular sex of patient, in the use of preventive intervention strategies for alcohol abuse by primary care physicians should be further explored.