Certain medical conditions linked to alcohol misuse
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Patients with certain medical conditions who consume alcohol may be at an increased risk for consuming more than the recommended limit, according to research published in JAMA Network Open.
“Patients with most medical conditions, compared with those without, were more likely to report no alcohol use than to drink at low-risk or high-risk levels,” Stacy A. Sterling, DrPH, MSW, MPH, a research scientist at the Kaiser Permanente Division of Research, and colleagues wrote. “However, people with diabetes, hypertension, COPD, and chronic liver disease who reported drinking were more likely than those without to drink at unhealthy levels, potentially exacerbating their conditions and jeopardizing treatment regimens.”
Sterling and colleagues conducted a cross-sectional study of primary care patients who were assessed for unhealthy drinking patterns using electronic health record screening questions. The questions were taken from a guide for primary care physicians developed by the National Institute on Alcohol Abuse and Alcoholism.
Patients were screened from January 2014 through December 2017 within the Kaiser Permanente Northern California health care system.
A total of 2,720,231 patients aged 18 to 65 years were included in the study. Aside from those who reported poisoning or injury, patients with a medical condition were more likely to report that they did not use alcohol compared with those without a medical condition, according to the researchers.
Among those who reported alcohol use (n = 861,427), Sterling and colleagues found that those with diabetes (OR = 1.11; 95% CI, 1.08-1.15), COPD (OR = 1.16; 95% CI,1 .1-1.22) and hypertension (OR = 1.11; 95% CI, 1.09-1.13) had higher odds of exceeding daily recommended alcohol consumption.
They identified increased odds for exceeding weekly alcohol use in patients with atrial fibrillation (OR = 1.12; 95% CI, 1.06-1.18), cancer (OR = 1.06; 95% CI,1.03-1.1), COPD (OR = 1.15; 95% CI, 1.09-1.2) and hypertension (OR = 1.37; 95% CI, 1.34-1.4).
Meanwhile, patients with COPD (OR = 1.15; 95% CI, 1.07-1.23), chronic liver disease (OR = 1.42; 95% CI, 1.32-1.53) and hypertension (OR = 1.48; 95% CI, 1.44-1.52) had higher odds for going over both daily and weekly limits.
In an editorial accompanying the study, Emily C. Williams, PhD, MPH, associate professor of health services and director of the doctoral program in health services at the University of Washington, wrote that substantial policy changes are likely needed to address the growing burden of alcohol use in the United States.
However, she explained, routine screening can help improve clinical care by allowing physicians to monitor patients’ consumption over time — particularly in those with conditions that place them at an increased risk for alcohol-related harm.
“Data such as those presented by Sterling [and colleagues] highlight the wealth of information that can be offered to providers on patients’ alcohol consumption over time in health care systems with population-based screening,” she wrote. “Clinicians and health care systems should capitalize on this resource to improve the quality of alcohol-related care and combat the large and increasing threat of alcohol use in the U.S.” – by Erin Michael
Disclosures: Sterling reported receiving grants from the National Institute on Alcohol Abuse and Alcoholism during the conduct of the study. Williams reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.