U PREVENTIVE SERVICES TASK FORCE ...

U PREVENTIVE SERVICES TASK FORCE

This statement summarizes the U Preventive Services Task Force (USPSTF) recommendations in succession behavioral counseling interventions to cut down alcohol misuse in primary care patients and the supporting evidence, and it updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, other edition. (1) Explanations of the ratings and of the power of overall evidence are given in Tables 1 and 2 respectively. The article summarizing the effectiveness of interventions in the adult population (2) and the systematic evidence review (3) upon this topic can be obtained in consequence of the USPSTF Web site (http://www.preventiveservices.ahrq.gov) and in consequence of the National Guideline Clearinghouse (http://www.guideline.gov). The article and the USPSTF recommendation statement also are available in print from one side the Agency for Healthcare Research and Quality (AHRQ) Publications Clearinghouse (phone 800-358-9295; e-mail, ahrqpubs@ahrq.gov). Recommendations made by means of the USPSTF are independent of the U sway They should not be constru as an official position of AHRQ or the U Department of Health and Human Services.

This recommendation first appeared in Ann Intern M 2004;140:555-7

Summary of Recommendations

* The USPSTF make acceptables screening and behavioral counseling interventions to abate alcohol misuse (see Clinical Considerations) by means of adults, including pregnant women, in primary care settings. B recommendation.

The USPSTF construct good evidence that screening in primary care settings can accurately identify patients whose of the same heights or patterns of alcohol consumption do not convenient criteria for alcohol dependence if it were not that place them at risk for increased morbidity and mortality, and advantageous evidence that brief behavioral counseling interventions with follow-up effect small to moderate reductions in alcohol consumption that are sustained above six- to 12-month periods or longer The USPSTF set up some evidence that interventions lead to positive health issues four or more years postintervention on the other hand found limited evidence that screening and behavioral counseling attenuate alcohol-related morbidity. The evidence in succession the effectiveness of counseling to curtail alcohol consumption during pregnancy is limited; however, studies in the general adult population point out to that behavioral counseling interventions are effective among women of childbearing age. The USPSTF conclud that the benefits of behavioral counseling interventions to abridge alcohol misuse by adults outweigh any potential harms.

* The USPSTF decides that the evidence is insufficient to commend for or against screening and behavioral counseling interventions to obstruct or reduce alcohol misuse according to adolescents in primary care settings. I recommendation.

The USPSTF set up limited evidence evaluating the effectiveness of screening and behavioral counseling interventions in primary care settings to impede or reduce alcohol misuse according to adolescents. The USPSTF concluded that the evidence is insufficient to assess the potential benefits and harms of screening and behavioral counseling interventions in this population.

Clinical Considerations

* Alcohol misuse includes "risky/hazardous" and "harmful" drinking that places individuals at risk for futurity problems. Risky or hazardous drinking has been defined in the United States as more than seven drinks by week or more than three drinks by occasion for women, and more than 14 drinks by week or more than four drinks through occasion for men. Harmful drinking describes living bodys who are experiencing physical, social, or psychologic harm from alcohol use nevertheless do not meet criteria for concatenation (4,5) Alcohol abuse and supporter is associated with repeated negative physical, psychologic, and social consequences from alcohol. (6) The USPSTF did not evaluate the effectiveness of interventions for alcohol connection because the benefits of these interventions are well established and referral or specialty treatment is attract favor toed for patients meeting the diagnostic criteria for dependence

* Light to moderate alcohol consumption in middle-aged or older adults has been associated with near health benefits, such as reduc risk for coronary heart disease. (7) Moderate drinking has been defined as sum of two units standard drinks (e.g., 12 ounce of beer) or les through day for men and undivided drink or less per day for women and [i]role[/i]s older than 65, (8) yet recent data suggest comparable benefits from as little as single drink three to four times a week. (9)

* The Alcohol Use Disorders Identification proof (AUDIT) is the most studied screening tool for detecting alcohol-related puzzles in primary care settings. It is sensitive for detecting alcohol misuse and abuse or buttress and can be used alone or embedded in broader health risk or lifestyle assessments. (1011) The four-item CAGE questionnaire (feeling the ne to wound down, Annoyed by criticism, Guilty about drinking, and ne for an Eye-opener in the morning) is the greatest in quantity popular screening test for detecting alcohol abuse or buttress in primary care. (12) The five-item TWEAK scale (Tolerance, Worry, Eye-opener Amnesia, (K) wound down) and the T-ACE questionnaire (Tolerance, Annoyance, divide [i]or[/i] sever down, Eye-opener) are designed to cover pregnant women for alcohol misuse. They ascertain lower levels of alcohol consumption that may stagger risks during pregnancy. (13) Clinicians can pitch upon screening strategies that are appropriate for their clinical population and setting. (1114-17) Screening tools are available at the National Institute forward Alcohol Abuse and Alcoholism Web site: http://www.niaaa.nih.gov/publications/niaaa-guide.