Screening for Alcoholism in the Primary Care Setting

Limitations

There are several limitations to our study. A number of reasons, including forgetfulness or inattention, may account for under-reporting. An overall problem with memory is unlikely, since almost all respondents remembered at least one discussion about some kind of health risk. Nonetheless, patients may be selectively less likely to recall a discussion about alcohol because of emotional associations with the topic. However, it is unclear why memory would be less reliable about alcohol use than memory about another potentially emotionally-charged topic, such as AIDS.

Additionally, our information was self-reported through a telephone interview. There have been positive study results published that validate the BRFSS survey data on alcohol consumption.^27,28 Nevertheless, the potential remains that respondents underestimate their alcohol use, and this might lead to false-negatives. Furthermore, the nature of the BRFSS question for alcohol discussions is somewhat ambiguous since we do not know if the discussion was a screening for excessive drinking or simply educational counseling.

Conclusions

Ideally, alcohol screening should occur in all primary care office visits, but given the extreme time constraints in the clinic setting, identification of under-recognized groups for targeted screening may enhance the recognition of alcohol abuse in a most time-effective manner.