Utility of routine alcohol screening for monitoring changes in alcohol consumption
Open accessAbstract
Background Routine alcohol screening scores are increasingly available in electronic health records (EHRs). Changes in such scores could be useful for monitoring response to brief intervention or treatment of alcohol use disorder. However, it is unclear whether changes in clinically-documented AUDIT-C alcohol screening scores reflect true changes in drinking. This study evaluated associations between changes in EHR AUDIT-C scores and changes in high density lipoprotein cholesterol (HDL), a laboratory test that reflects average alcohol consumption.Methods National U.S. Veterans Affairs EHR data (2004-2007) were used to identify patients screened with the AUDIT-C (0-12 points), on two occasions at least a year apart, who had HDL measured in the year after each screen. First differencing linear regression estimated associations between changes in AUDIT-C score (-12 to 12 points; modeled categorically to allow for non-linear associations) and subsequent changes in HDL (mg/dL), adjusting for baseline HDL. Additional analyses evaluated whether associations between changes in AUDIT-C and changes in HDL were modified by baseline AUDIT-C.Results Among 316,712 patients, increases-but not decreases-in AUDIT-C scores were associated with commensurate changes in HDL. However, a significant interaction was observed with baseline AUDIT-C score (p < 0.00001), which revealed that decreases in AUDIT-C scores were also associated with commensurate decreases in HDL (p-values<0.05) except among the 1.5% of patients with the highest baseline AUDIT-C scores (10-12).Conclusions Findings suggest that changes in EHR AUDIT-C scores reflect changes in drinking. These results support the use of clinically-documented alcohol screening scores for monitoring patients' alcohol use over time.
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Previous research has demonstrated that changes in AUDIT-C scores over one year do reflect changes in drinking for adults and can predict future problematic drinking in adolescents.
“Previous research has demonstrated that changes in AUDIT-C scores over one year do reflect changes in drinking for adults and can predict future problematic drinking in adolescents [48,56].”
From Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People (2023) · cites this paper as [56]
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“Previous research has demonstrated that changes in AUDIT-C scores over one year do reflect changes in drinking for adults and can predict future problematic drinking in adolescents [48,56].”
- Authors
- Rubinsky, A. D., Chavez, L. J., Berger, D., Lapham, G. T., Hawkins, E. J., Williams, E. C., & Bradley, K. A.
- Affiliations
- University of California, San Francisco (US)
- The Ohio State University (US)
- University of Washington (US)
- Kaiser Permanente Washington Health Research Institute (US)
- Corresponding author
- Rubinsky, Anna D.
- ORCID
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2019-08
- Volume
- 201
- Pages
- 155-160
- ISSN
- 0376-8716 (ISSN-L)
- PMC
- PMC7001877
- OpenAlex
- W2944788938
- Cited by
- 20
- References
- 31
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 2 · 2020: 5
- FWCI
- 1.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs (VA), Veterans Health Administration, Office of Research and Development, Health Services Research and Development (IIR 08-314)
- Career Development Award from VA HSR&D (CDA 12-276)
- U.S. National Institute on Alcohol Abuse and Alcoholism (K24 AA022128)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Keywords
- alcohol screening, AUDIT-C, alcohol consumption monitoring, HDL cholesterol, electronic health records, alcoholism, brief intervention, veterans
- MeSH terms
- Adult, Aged, Alcohol Drinking, Alcoholism, Female, Humans, Cholesterol, HDL, Longitudinal Studies, Male, Mass Screening, Middle Aged, United States, Cohort Studies, Young Adult
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