The USPSTF encouraged primary care clinicians to screen adults over the age of 18, including pregnant women, with unhealthy alcohol use, based on evidence studies. If the patient is found to be involved in dangerous or dangerous drinking, the clinician should provide simple behavior counseling to reduce unhealthy alcohol use. This is a "B" recommendation.(www.uspreventiveservicestaskforce.org)
"In this last recommendation, the Task Force urged clinicians to screen all adults and provide counseling to those who drink above the recommended limits," USPSTF members Carol Mangione, MD, M.S.P.H said in a press release.(www.uspreventiveservicestaskforce.org) "We found that screening and brief counseling at primary care can help to reduce unhealthy drinking. Because alcohol use during pregnancy can lead to birth defects and developmental disabilities, it is particularly important to deal with this problem between pregnant women It is important."
Task Force members said current evidence is insufficient to assess the effectiveness and harmful balance of screening and behavior counseling interventions in primary care settings for 12-17 year olds.
"We continue to do more research and encourage the doctor to use his / her judgment when deciding whether to screen the juvenile clinic," said Dr Sue Curry of the USPSTF.
Task Force defined non-healthful alcohol use as drinking beyond the limit recommended by the National Alcohol Abuse and Alcoholism (NIAA).(www.niaaa.nih.gov)
- Men can not drink more than four cups a day and can not drink more than 14 cups per week.
- Women can not drink more than 3 cups per day and should not drink more than 7 cups per week.
The screening involves asking a series of questions about how often the doctor drinks with the patient and asking for other drinking patterns. If the patient is found to be involved in dangerous or dangerous drinking, the physician should conduct simple behavior counseling to reduce unhealthy alcohol use. These simple interventions typically include a discussion of how the patient's drinking is compared to the recommended limits and how to reduce alcohol consumption.
Patients with a more severe alcohol use disorder (AUD) may be recommended for more extensive treatment.
This final recommendation is in line with the USPSTF's June draft Recommendation and the 2013 Final Recommendation,(www.uspreventiveservicestaskforce.org) At that time, the AAFP supported this.
In the 2013 Recommendation, the Task Force used the term "alcohol abuse" to define broad drinking behaviors (eg, use of dangerous or dangerous alcohol, harmful alcohol use, alcohol abuse, or dependence). In the current final recommendation, however, the USPSTF uses the term "unhealthy use" of the American Society of Addiction Medicine, which results in increased health risks, It is defined as the use of one alcohol.
Final recommendations details
The USPSTF has commissioned a systematic review of the evidence to update the 2013 recommendations for these types of inspections. This review examined the effectiveness of screening to reduce unhealthy drinking, morbidity, mortality or risky behavior and improve health, social or legal outcomes.
The Task Force also assessed the accuracy of the various screening approaches, the effectiveness of counseling interventions to reduce unhealthy alcohol use and improve patient outcomes, and the outcome of screening and behavioral intervention interventions.
Regarding screening tools, the USPSTF determined that the 1 to 3-item screening tool was the most accurate in assessing adult unhealthy alcohol use. Such tools include abbreviated alcohol use disorder identification test consumption and NIAAA recommended single alcohol screening questions. The Task Force has discounted the use of well-known CAGE (Cut, Annoyed, Guilty, Eye-opener) tools because it only detects alcohol dependence and does not detect unhealthy alcohol use.
You can use screening tools for specific populations, including pregnant women. On the positive screen, you need an in-depth assessment to check for unhealthy alcohol use and decide on the next steps.
The USPSTF also found that behavioral counseling interventions for non-healthful alcohol use vary according to their specific components, dosage, length and number of interactions. Nearly all interventions included four or fewer sessions, including the median of one session. Most interventions consisted of 2 hours of contact time or 30 minutes of average contact time.
Answers to public comments
The draft of this recommendation was published publicly on the USPSTF website from June 5 to July 2.
Some commentators say they are concerned that there is a lack of discussion of a specific population.
The USPSTF has added language on youth drinking risk to Clinical Considerations(www.uspreventiveservicestaskforce.org) Harm on drinking and drinking during pregnancy(www.uspreventiveservicestaskforce.org) section.
Since other commenters made clear what sort of screening tools were being discussed, we detailed the tools by adding the "Useful Resources" subtitle in the Clinical Considerations section of the Special Considerations section.
The AAFP Public and Scientific Health Committee will review the USPSTF's final recommendation statements and evidence and determine its position on the Academy's recommendations.
relation AAFP News Coverage
CDC providing fetal alcohol spectrum disorder
AAFP resources required by agencies
AAFP, Baylor, Alcohol Screening Practice Manual Authoring Partner
(July 20, 2011)
More from AAFP
Alcohol Use Practice Manual Addressing(466 KB PDF)
Familydoctor.org: Alcohol Abuse(familydoctor.org)