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AHRQ Research Studies Date
Topics
- (-) Alcohol Use (26)
- Ambulatory Care and Surgery (2)
- Behavioral Health (4)
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- Children/Adolescents (3)
- Comparative Effectiveness (1)
- Diagnostic Safety and Quality (1)
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- Patient-Centered Outcomes Research (1)
- Policy (1)
- Practice Patterns (1)
- Prevention (3)
- Primary Care (5)
- Primary Care: Models of Care (1)
- Racial and Ethnic Minorities (1)
- Risk (1)
- Screening (6)
- Substance Abuse (20)
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- Transplantation (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 26 Research Studies DisplayedShen NT, Bray J, Wahid NA
Evaluation of alcohol taxes as a public health opportunity to reduce liver transplant listings for alcohol-related liver disease.
Alcohol-related liver disease (ALD) is a leading indication for liver transplantation. In this study, the investigators evaluated alcohol taxes as a public health opportunity to reduce liver transplant listings for alcohol-related liver disease. The investigators concluded that transplant listings for ALD were directly associated with spirit consumption and inversely associated with spirits excise taxes. They indicate that these findings suggest a possible public health benefit of increasing excise taxes for spirits.
AHRQ-funded; HS000066.
Citation: Shen NT, Bray J, Wahid NA .
Evaluation of alcohol taxes as a public health opportunity to reduce liver transplant listings for alcohol-related liver disease.
Alcohol Clin Exp Res 2020 Nov;44(11):2307-15. doi: 10.1111/acer.14454..
Keywords: Alcohol Use, Policy, Transplantation
Steele DW, Becker SJ, Danko KJ
Brief behavioral interventions for substance use in adolescents: a meta-analysis.
Adolescents with problematic substance use (SU) are at risk for far-reaching adverse outcomes. The objective of this study was to synthesize the evidence regarding the effects of brief behavioral interventions for adolescents (12-20 years) with problematic SU. The investigators concluded that the use of a behavioral intervention called motivational interviewing reduced heavy alcohol use, alcohol use days, and SU-related problems in adolescents but did not reduce cannabis use days.
AHRQ-funded; 290201500002I.
Citation: Steele DW, Becker SJ, Danko KJ .
Brief behavioral interventions for substance use in adolescents: a meta-analysis.
Pediatrics 2020 Oct;146(4):e2020351. doi: 10.1542/peds.2020-0351..
Keywords: Children/Adolescents, Substance Abuse, Alcohol Use, Treatments
Wisk LE, Magane KM, Levy S
Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth.
Youth with chronic medical conditions (YCMC) use alcohol at levels similar to their healthy peers but face elevated risk for adverse health consequences. As salient reasons to abstain from or limit drinking (RALD) among YCMC are unknown, the investigators sought to identify clusters of RALD and test associations with use behaviors. The investigators concluded that for YCMC, RALD were complex but endorsement of multiple general and health-related RALD was associated with less use, and health concerns are especially prevalent.
AHRQ-funded; HS022986.
Citation: Wisk LE, Magane KM, Levy S .
Alcohol use behaviors and reasons to abstain from or limit drinking among medically vulnerable youth.
J Addict Med 2020 Jul/Aug;14(4):311-18. doi: 10.1097/adm.0000000000000603..
Keywords: Children/Adolescents, Alcohol Use, Behavioral Health, Vulnerable Populations, Substance Abuse
Burner E, Zhang M, Terp S
Feasibility and acceptability of a text message-based intervention to reduce overuse of alcohol in emergency department patients: controlled proof-of-concept trial.
The objective of this study was to assess the feasibility of and patient satisfaction with a text-based mHealth extension of an emergency department (ED) screening program to reduce risky alcohol use in low-income, urban patients. A case-control study was designed using a SMS text message-capable phones to receive mROAD (mobilizing to Reduce Overuse of Alcohol in the ED), an SMS text message-based extension of the ED screening program. mROAD is a 7-day program of twice-daily SMS text messages based on the NIH Health Rethinking Drinking campaign. Of 1028 patients screened, 9.2% exhibited risky alcohol use based on the Alcohol Use Disorders Identification Test (AUDIT) in the ED. Almost a quarter of the patients did not have an SMS text-messaging capable phone, leaving 76% eligible patients. Changes in behavior were similar between the two groups. The number of drinking days reported in the prior 30 days decreased by 5 and the number of heavy drinking days decreased by 4.1. Patients reported an 11-point increase in motivation to change alcohol use via the Change Questionnaire.
AHRQ-funded; HS022402.
Citation: Burner E, Zhang M, Terp S .
Feasibility and acceptability of a text message-based intervention to reduce overuse of alcohol in emergency department patients: controlled proof-of-concept trial.
JMIR Mhealth Uhealth 2020 Jun 4;8(6):e17557. doi: 10.2196/17557..
Keywords: Alcohol Use, Substance Abuse, Emergency Department, Telehealth, Health Information Technology (HIT), Screening, Prevention
Rogal S, Youk A, Zhang H
Impact of alcohol use disorder treatment on clinical outcomes among patients with cirrhosis.
Despite significant medical and economic consequences of coexisting alcohol use disorder (AUD) in patients with cirrhosis, little is known about AUD treatment patterns and their impact on clinical outcomes in this population. In this study the investigators aimed to characterize the use of and outcomes associated with AUD treatment in patients with cirrhosis. This retrospective cohort study included Veterans with cirrhosis who received Veterans Health Administration (VA) care and had an index diagnosis of AUD between 2011 and 2015.
AHRQ-funded; HS019461.
Citation: Rogal S, Youk A, Zhang H .
Impact of alcohol use disorder treatment on clinical outcomes among patients with cirrhosis.
Hepatology 2020 Jun;71(6):2080-92. doi: 10.1002/hep.31042..
Keywords: Alcohol Use, Substance Abuse, Patient-Centered Outcomes Research, Outcomes
Kuhns LM, Carlino B, Greeley K
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
This study looked at rates of substance use screening and related documentation among adolescents aged 12-17 in outpatient pediatric clinics in a large academic medical center. The authors abstracted a random sample of 127 records and coded clinical notes to describe screening cases and related characteristics. They then analyzed descriptive patterns within the data to calculate screening rates, characteristics of screening, and identify related factors. Rates of screening by providers was 72% for each common substance and a total of 6% of patients reported substance use during screening.
AHRQ-funded; HS026385.
Citation: Kuhns LM, Carlino B, Greeley K .
A chart review of substance use screening and related documentation among adolescents in outpatient pediatric clinics: implications for practice.
Subst Abuse Treat Prev Policy 2020 May 25;15(1):36. doi: 10.1186/s13011-020-00276-4..
Keywords: Children/Adolescents, Substance Abuse, Screening, Ambulatory Care and Surgery, Alcohol Use, Practice Patterns, Primary Care
Huffstetler AN, Kuzel AJ, Sabo RT
Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial.
Investigators are initiating a clinic-level randomized controlled trial aimed to evaluate how primary care clinicians can impact unhealthy alcohol use through screening, counseling, and medication-assisted therapy (MAT). After completion of the intervention, researchers will conduct a mixed methods analysis to identify changes in screening rates, increase in provision of brief counseling and interventions as well as MAT, and the reduction of alcohol intake for patients after practices receive practice facilitation. They propose practice facilitation as a robust and feasible intervention to assist in making changes within the practice and believe that the process can be replicated and used in a broad range of clinical settings. They anticipate that these statements will be supported by their evaluation of this approach.
AHRQ-funded; HS027077.
Citation: Huffstetler AN, Kuzel AJ, Sabo RT .
Practice facilitation to promote evidence-based screening and management of unhealthy alcohol use in primary care: a practice-level randomized controlled trial.
BMC Fam Pract 2020 May 20;21(1):93. doi: 10.1186/s12875-020-01147-4..
Keywords: Alcohol Use, Primary Care, Primary Care: Models of Care, Screening, Care Management, Prevention
Sayre M, Lapham GT, Lee AK
Routine assessment of symptoms of substance use disorders in primary care: prevalence and severity of reported symptoms.
This study looked at the prevalence and severity of DSM-5 substance use disorders (SUDs) reported by primary care (PC) patients as part of routine care. This cross-sectional study used data from 241,265 adult patients who visited one of 25 PC sites in an integrated health system in Washington state and had alcohol, cannabis, or other drug use screening documented in their electronic health records from March 2015-July 2018. A scale of Symptom Checklists (0-11) was used based on DSM-5 with 2-3 rated as mild, 4-5 moderate, and 6-11 severe. Out of those screened patients, 16,775 (5.7%) reported high-risk use of alcohol (2.4%), cannabis (3.9%), and/or other drugs (1.7%) with 65-70% completing the Symptom Checklists. Of those with high-risk alcohol use, 52.5% reported 2 or more symptoms consistent with mild-severe alcohol use disorders. Mild-severe symptoms were reported by 29.8% of patients reporting daily cannabis use, and 37.5% of patients reporting any other drug use had 2 or greater symptoms.
AHRQ-funded; HS023173.
Citation: Sayre M, Lapham GT, Lee AK .
Routine assessment of symptoms of substance use disorders in primary care: prevalence and severity of reported symptoms.
J Gen Intern Med 2020 Apr;35(4):1111-19. doi: 10.1007/s11606-020-05650-3..
Keywords: Substance Abuse, Alcohol Use, Primary Care, Diagnostic Safety and Quality
BJ BJ, McGinnis KA, Edelman EJ
Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV.
Researchers examined predictors of medications for alcohol use disorder initiation and retention across HIV status. Data from the Veterans Aging Cohort Study data was used to identify new alcohol use disorder diagnoses among 163,339 individuals from 1998 to 2015. The researchers found that the low frequency of retention precluded multivariable analyses for retention. They concluded that, for people living with HIV and uninfected individuals, targeted implementation strategies to expand medications for alcohol use disorder are needed, particularly for specific subpopulations.
AHRQ-funded; HS021112.
Citation: BJ BJ, McGinnis KA, Edelman EJ .
Predictors of initiation of and retention on medications for alcohol use disorder among people living with and without HIV.
J Subst Abuse Treat 2020 Feb;109:14-22. doi: 10.1016/j.jsat.2019.11.002..
Keywords: Alcohol Use, Substance Abuse, Medication, Human Immunodeficiency Virus (HIV)
Lipira L, Rao D, Nevin PE
Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV.
The authors used baseline data from a randomized controlled trial of an HIV-related stigma-reduction intervention among African-American women living with HIV in Chicago and Birmingham. They measured patterns of alcohol use, then assessed demographic, social, and clinical characteristics which may influence alcohol use and HIV-related outcomes which may be influenced by patterns of alcohol use. Their findings suggest that alcohol use is common and associated with poor HIV-related outcomes in this population. They recommended that regular alcohol screening and intervention be offered.
AHRQ-funded; HS013853.
Citation: Lipira L, Rao D, Nevin PE .
Patterns of alcohol use and associated characteristics and HIV-related outcomes among a sample of African-American women living with HIV.
Drug Alcohol Depend 2020 Jan 1;206:107753. doi: 10.1016/j.drugalcdep.2019.107753..
Keywords: Human Immunodeficiency Virus (HIV), Alcohol Use, Racial and Ethnic Minorities, Women, Substance Abuse
Cochran G, Field C, DiClemente C
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
The purpose of this study was to identify differential improvement in alcohol use among injured patients following brief intervention. Increases in both clinical trials for days abstinent were reported by classes characterized by multiple risks and minimal risks. Decreases in volume consumed for both studies were also reported by classes characterized by multiple risks and minimal risks.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, DiClemente C .
Latent classes among recipients of a brief alcohol intervention: a replication analysis.
Behav Med 2016;42(1):29-38. doi: 10.1080/08964289.2014.951305.
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Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Treatments
Bradley KA, Lapham GT
Is it time for a more ambitious research agenda for decreasing alcohol-related harm among young adults?
The authors commented that brief motivational interviewing-based interventions could probably impact drinking at the population level. They noted that there is a critical need to develop and test more effective interventions and recommended that the public health approach to preventing alcohol-related harm among young adults include known effective approaches, including those that decrease alcohol use by reducing the availability of alcohol.
AHRQ-funded; HS023173.
Citation: Bradley KA, Lapham GT .
Is it time for a more ambitious research agenda for decreasing alcohol-related harm among young adults?
Addiction 2016 Sep;111(9):1531-2. doi: 10.1111/add.13235.
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Keywords: Alcohol Use, Lifestyle Changes, Prevention, Substance Abuse, Young Adults
Clark BJ, Rubinsky AD, Ho PM
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
This study sought to determine whether alcohol misuse was associated with admission to an intensive care unit (ICU) among patients receiving outpatient care. Among 486,115 veterans receiving outpatient care, the adjusted probability of ICU admission within 1 year was 2.0 percent for abstinent patients, 1.6 percent for patients with lower-risk alcohol use, 1.8 percent for patients with moderate alcohol misuse, and 2.5 percent for patients with severe alcohol misuse.
AHRQ-funded; HS022800.
Citation: Clark BJ, Rubinsky AD, Ho PM .
Alcohol screening scores and the risk of intensive care unit admission and hospital readmission.
Subst Abus 2016 Jul-Sep;37(3):466-73. doi: 10.1080/08897077.2015.1137259.
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Keywords: Alcohol Use, Hospital Readmissions, Intensive Care Unit (ICU), Ambulatory Care and Surgery, Screening, Substance Abuse
Chavez LJ, Williams EC, Lapham GT
Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.
The researchers examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. They found that among patients with alcohol misuse, the adjusted prevalence of alcohol-related advice increased from 40.4% in 2007 to 55.5% in 2011. Rates of alcohol-related advice increased significantly each year except the last.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Williams EC, Lapham GT .
Changes in patient-reported alcohol-related advice following veterans health administration implementation of brief alcohol interventions.
J Stud Alcohol Drugs 2016 May;77(3):500-8.
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Keywords: Alcohol Use, Behavioral Health, Primary Care, Substance Abuse
Heslin KC, Elixhauser A, Steiner CA
AHRQ Author: Heslin KC, Elixhauser A, Steiner CA
Identifying in-patient costs attributable to the clinical sequelae and comorbidities of alcoholic liver disease in a national hospital database.
The aim of this study was to compare the average costs of hospitalizations with alcoholic liver disease (ALD) and the costs of hospitalizations with other alcohol-related diagnoses that do not involve the liver. It found that costs of hospital care for patients with ALD are higher than those for patients with other alcohol-related diagnoses.
AHRQ-authored.
Citation: Heslin KC, Elixhauser A, Steiner CA .
Identifying in-patient costs attributable to the clinical sequelae and comorbidities of alcoholic liver disease in a national hospital database.
Addiction 2016 May;112(5):782-91. doi: 10.1111/add.13702.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Alcohol Use, Healthcare Costs, Nutrition, Hospitalization
Chavez LJ, Bradley K, Tefft N
Preference weights for the spectrum of alcohol use in the U.S. population.
One barrier to research has been the lack of preference weights needed to calculate Quality Adjusted Life Years (QALYs). Preference weights can be estimated from measures of health-related quality of life (HRQOL). The objective of this study was to describe preference weights for the full spectrum of alcohol use. It concluded that self-reported alcohol consumption may not be associated with preference weights.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Bradley K, Tefft N .
Preference weights for the spectrum of alcohol use in the U.S. population.
Drug Alcohol Depend 2016 Apr 1;161:206-13. doi: 10.1016/j.drugalcdep.2016.02.004.
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Keywords: Medical Expenditure Panel Survey (MEPS), Alcohol Use, Substance Abuse, Health Status
Rentsch C, Tate JP, Akgun KM
Alcohol-related diagnoses and all-cause hospitalization among HIV-infected and uninfected patients: a longitudinal analysis of United States veterans from 1997 to 2011.
From 1997 to 2011, 46,428 HIV-infected and 93,997 uninfected patients were followed for 1,497,536 person-years. Overall hospitalization rates decreased among HIV-infected and uninfected patients. However, cardiovascular and renal insufficiency admissions increased for all groups while gastrointestinal and liver, endocrine, neurologic, and non-AIDS cancer admissions increased among those with an alcohol-related diagnosis.
AHRQ-funded; HS018372.
Citation: Rentsch C, Tate JP, Akgun KM .
Alcohol-related diagnoses and all-cause hospitalization among HIV-infected and uninfected patients: a longitudinal analysis of United States veterans from 1997 to 2011.
AIDS Behav 2016 Mar;20(3):555-64. doi: 10.1007/s10461-015-1025-y.
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Keywords: Alcohol Use, Hospitalization, Human Immunodeficiency Virus (HIV)
Liu L, Strawderman RL, Johnson BA
Analyzing repeated measures semi-continuous data, with application to an alcohol dependence study.
The authors reviewed and considered three extensions of two-part random effects models. They compared the performance through applications to daily drinking records in a secondary data analysis from a randomized controlled trial of topiramate for alcohol dependence treatment. They found that all three models provide a significantly better fit than the log-normal model, and there exists strong evidence for heteroscedasticity.
AHRQ-funded; HS020263.
Citation: Liu L, Strawderman RL, Johnson BA .
Analyzing repeated measures semi-continuous data, with application to an alcohol dependence study.
Stat Methods Med Res 2016 Feb;25(1):133-52. doi: 10.1177/0962280212443324.
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Keywords: Alcohol Use, Behavioral Health, Substance Abuse
Williams EC, Achtmeyer CE, Young JP
Local implementation of alcohol screening and brief intervention at five Veterans Health Administration primary care clinics: Perspectives of clinical and administrative staff.
The researchers conducted a qualitative key informant study to describe local implementation of alcohol screening and brief intervention from the perspectives of frontline adopters in VA primary care . Findings suggest that the local process of implementing alcohol screening and brief intervention may have inadequately addressed important adopter needs.
AHRQ-funded; HS022800.
Citation: Williams EC, Achtmeyer CE, Young JP .
Local implementation of alcohol screening and brief intervention at five Veterans Health Administration primary care clinics: Perspectives of clinical and administrative staff.
J Subst Abuse Treat 2016 Jan;60:27-35. doi: 10.1016/j.jsat.2015.07.011.
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Keywords: Alcohol Use, Screening, Primary Care
Chavez LJ, Liu CF, Tefft N
Unhealthy alcohol use in older adults: association with readmissions and emergency department use in the 30 days after hospital discharge.
This study examined the association between AUDIT-C alcohol screening results and 30-day readmissions or ED visits. Alcohol screening results indicating high-risk drinking that were available in medical records were modestly associated with risk for 30-day readmissions and were not associated with risk for ED visits.
AHRQ-funded; HS022800.
Citation: Chavez LJ, Liu CF, Tefft N .
Unhealthy alcohol use in older adults: association with readmissions and emergency department use in the 30 days after hospital discharge.
Drug Alcohol Depend 2016 Jan;158:94-101. doi: 10.1016/j.drugalcdep.2015.11.008.
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Keywords: Alcohol Use, Elderly, Emergency Department, Hospital Readmissions, Lifestyle Changes
Lapham GT, Rubinsky AD, Williams EC
Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics.
The purpose of this study was to evaluate the performance of repeat annual clinical alcohol screening in 4 samples of VA outpatients with 1–4 prior consecutive negative annual screens. It found that among patients with repeated negative clinical alcohol screens, the proportion who subsequently screened positive a year later was low and decreased as patients had more prior negative screens.
AHRQ-funded; HS022800.
Citation: Lapham GT, Rubinsky AD, Williams EC .
Decreasing sensitivity of clinical alcohol screening with the AUDIT-C after repeated negative screens in VA clinics.
Drug Alcohol Depend 2014 Sep 1;142:209-15. doi: 10.1016/j.drugalcdep.2014.06.017..
Keywords: Screening, Alcohol Use, Substance Abuse
Jonas DE, Amick HR, Feltner C
Genetic polymorphisms and response to medications for alcohol use disorders: a systematic review and meta-analysis.
This review assessed whether response to medications for alcohol use disorders varies by genotype. It found that estimates of effect for return to heavy drinking suggest it is possible that patients with at least one G allele of A118G polymorphism of OPRM1 might be more likely to respond to naltrexone.
290201200008I; 29032002T
Citation: Jonas DE, Amick HR, Feltner C .
Genetic polymorphisms and response to medications for alcohol use disorders: a systematic review and meta-analysis.
Pharmacogenomics 2014 Sep;15(13):1687-700. doi: 10.2217/pgs.14.121..
Keywords: Medication, Alcohol Use, Substance Abuse, Genetics
Jonas DE, Amick HR, Feltner C
Genetic polymorphisms and response to medications for alcohol use disorders: a systematic review and meta-analysis.
This review assessed whether response to medications for alcohol use disorders varies by genotype. It found that estimates of effect for return to heavy drinking suggest it is possible that patients with at least one G allele of A118G polymorphism of OPRM1 might be more likely to respond to naltrexone.
290201200008I; 29032002T
Citation: Jonas DE, Amick HR, Feltner C .
Genetic polymorphisms and response to medications for alcohol use disorders: a systematic review and meta-analysis.
Pharmacogenomics 2014 Sep;15(13):1687-700. doi: 10.2217/pgs.14.121..
Keywords: Medication, Alcohol Use, Substance Abuse, Genetics
Hartung DM, McCarty D, Fu R
Extended-release naltrexone for alcohol and opioid dependence: a meta-analysis of healthcare utilization studies.
The authors evaluated cost and utilization outcomes between extended-release naltrexone (XR-NTX) and other pharmacotherapies for treatment of alcohol and opioid dependence. They found that alcohol dependent XR-NTX patients had longer medication refill persistence versus acamprosate and oral naltrexone, with healthcare utilization and costs being generally lower or as low for XR-NTX-treated patients relative to other alcohol dependence agents. Opioid dependent XR-NTX patients had lower inpatient substance abuse-related utilization versus other agents and $8170 lower total cost versus methadone.
AHRQ-funded; HS019456.
Citation: Hartung DM, McCarty D, Fu R .
Extended-release naltrexone for alcohol and opioid dependence: a meta-analysis of healthcare utilization studies.
J Subst Abuse Treat 2014 Aug;47(2):113-21. doi: 10.1016/j.jsat.2014.03.007.
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Keywords: Alcohol Use, Comparative Effectiveness, Medication, Opioids, Substance Abuse
Cochran G, Field C, Caetano R
Injury-related consequences of alcohol misuse among injured patients who received screening and brief intervention for alcohol: a latent class analysis.
This study identifies latent classes of intervention recipients based on injury-related consequences and risks of alcohol misuse and then determines which profiles experienced the greatest improvements in drinking. It found that the patients who reported the greatest improvements in drinking following discharge were those characterized by multiple alcohol-related risks and those characterized by a history of alcohol-related accidents and injuries.
AHRQ-funded; HS021394.
Citation: Cochran G, Field C, Caetano R .
Injury-related consequences of alcohol misuse among injured patients who received screening and brief intervention for alcohol: a latent class analysis.
Subst Abus 2014;35(2):153-62. doi: 10.1080/08897077.2013.820679..
Keywords: Alcohol Use, Substance Abuse, Risk