Few veterans at high risk for alcohol use disorder offered treatment

Results of a new study suggest primary care physicians need to be more proactive in referring treatment options to veterans with alcohol use disorder.

The finding is based on a study in the Journal of the American Board of Family Medicine, which found only 41.5% of veterans considered at high risk for alcohol use disorder were made aware of these options.

“Because patients with an [alcohol use disorder] generally do not visit primary care to seek alcohol misuse–related treatment, it is important to examine whether clinicians offer treatment when high risk for an [alcohol use disorder] is identified during screening, even if patients do not mention or ask for it,” Sean Grant, DPhil, of the Rand Corporation and colleagues wrote. “Health professionals in primary care settings may not be aware of the various evidence-based pharmacological or behavioral treatment options for patients with [alcohol use disorders]. Consequently, the type of treatment offered should also be examined to ensure that appropriate care is recommended.”

Grant and colleagues conducted phone interviews with 349 patients who received a score of 5 or higher on the Alcohol Use Disorders Identification Test Consumption questionnaire (AUDIT-C) during their normal annual doctor’s visit at a Veterans’ Affairs health care provider within the past 30 days. The mean age of the patients was 55 years. Analysis was limited to those who had been diagnosed with alcohol use disorder at the doctor’s visit and had not received treatment in the past 3 months, or those who scored 8 or greater on AUDIT-C. Researchers tried to ascertain if formal treatment was offered, and if so, what kind, and the predictors of patient-reported treatment offers.

Researchers wrote that 58.5% of patients reported they were not offered any formal treatment. For those who were offered treatment, therapy/counseling was the most frequent recommended treatment (n = 121), referral to intensive outpatient treatment or a residential program (n = 19), medication (n = 18), and therapy/counseling in combination with referral to either a residential program or intensive outpatient treatment program (n = 17). Only younger age (OR = 0.97; 95% CI, 0.95-0.99) and more severe alcohol misuse (OR = 1.07; 95% CI, 1.03-1.11) were linked to getting a formal treatment offer.

“This result conforms with research demonstrating low rates of offering patients information about formal treatment following alcohol screening,” Grant and colleagues wrote.

Researchers wrote future research should involve conducting surveys differently and evaluate what triggers treatment recommendations, as well as reimbursement for alcohol use disorder treatment. – by Janel Miller

Disclosure: Grant reports his spouse is a salaried employee of Eli Lilly & Company, owns stock and has accompanied his spouse on company-sponsored travel. All other researchers reported no relevant financial disclosures.