Beyond alcoholism: Identifying older, at-risk drinkers in primary care
Beyond alcoholism: Identifying older, at-risk drinkers in primary care
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DOI：
10.15288/jsa.2002.63.316
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发表时间：
2002-05-01
期刊：
影响因子：
--
通讯作者：
Reuben, DB
中科院分区：
文献类型：
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作者：
Moore, AA;Beck, JC;Reuben, DB
目的：评估两种自我报告工具的效度和可靠性：酒精相关问题调查（ARPS）及其简短版本的简短ARPS (shARPS)，以确定单独使用酒精或其合并症可能使他们处于危险或造成伤害的老年人。方法：我们在10个内科诊所的166名60岁及以上的饮酒者样本中，将这两种措施与“LEAD”（专家利用所有可用数据进行的纵向评估）标准进行了比较。LEAD标准包括医疗记录审查、临床访谈和与附带举报人的电话访谈。我们列出了LEAD确定受试者为有害或危险饮酒者的原因。我们还将酒精使用障碍鉴定测试（AUDIT）和短密歇根酒精中毒筛查测试（SMAST-G）与LEAD进行了比较。结果：与LEAD相比，ARPS和shARPS的敏感性分别为93%和63%，特异性分别为92%和51%。在对评分规则进行轻微修改后，ARPS和shARPS的特异性均增加到66%，而敏感性保持稳定。93%和91%。有害和危险饮酒者最常被确定为酒精使用的合并症、症状和药物使用。与LEAD相比，AUDIT和SMAST-G的敏感性和特异性分别为28%和100%，52%和96%。结论：ARPS和shARPS在识别有酒精使用障碍的老年饮酒者方面相当敏感。在确定可能因饮酒和共病而面临风险或遭受伤害的老年人方面，它们比审计和SMAST-G更为敏感。它们还提供了其他筛查措施无法获得的与饮酒相关的特定风险信息，因此可能有助于忙碌的临床医生采取干预措施，以减少此类风险。
Objective: To evaluate the validity and reliability of two self-report instruments: the Alcohol-Related Problems Survey (ARPS) and its shorter version the Short ARPS (shARPS) that identify older persons whose use of alcohol alone or with their comorbidities may be placing them at risk for or causing them harm. Method: We compared the two measures against a "LEAD" (longitudinal evaluation done by experts employing all available data) standard among a sample of 166 drinkers aged 60 years and older in 10 internal medicine clinics. The LEAD standard included a medical record review, a clinical interview and a telephone interview with a collateral informant. We tabulated reasons the LEAD identified subjects as harmful or hazardous drinkers. We also compared the Alcohol Use Disorders Identification Test (AUDIT) and the Short Michigan Alcoholism Screening Test-Geriatric Version (SMAST-G) to the LEAD. Results: Sensitivity and specificity of the ARPS and the shARPS as compared to the LEAD were 93% and 63%, and 92% and 51%, respectively. After minor changes were made in the scoring rules, specificity increased to 66% for both the ARPS and shARPS while sensitivity remained stable. 93% and 91%. Harmful and hazardous drinkers were most often identified because of alcohol use with comorbidities, symptoms, and medication use. Sensitivity and specificity of the AUDIT and the SMAST-G as compared to the LEAD were 28% and 100%, and 52% and 96%, respectively. Conclusions: The ARPS and shARPS are quite sensitive in identifying older drinkers with a spectrum of alcohol use disorders. They are more sensitive than the AUDIT and the SMAST-G in identifying older persons who may be at risk or experiencing harm as a result of their alcohol use and comorbidities. They also provide information on specific risks associated with alcohol use not obtained by other screening measures and may therefore facilitate interventions by busy clinicians to reduce such risks.