The effect of alcohol consumption on clinical outcomes in regional patients with chronic disease: a retrospective chart audit.
alcohol
chronic disease
clinical management
healthcare provision
Journal
Australian and New Zealand journal of public health
ISSN: 1753-6405
Titre abrégé: Aust N Z J Public Health
Pays: United States
ID NLM: 9611095
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
01
02
2020
revised:
01
05
2020
accepted:
01
06
2020
pubmed:
13
10
2020
medline:
15
12
2020
entrez:
12
10
2020
Statut:
ppublish
Résumé
To better understand the impact of alcohol consumption on the clinical management of chronic diseases in a regional general practice setting. A retrospective chart audit was undertaken of individual patient records at two large group general practices in Townsville, a regional Australian city. Three common indicator chronic diseases were selected that have clear management guidelines for general practice: type 2 diabetes; chronic obstructive pulmonary disease; and chronic kidney disease. The audits were analysed using SPSS software to examine the association between alcohol consumption on acquisition of clinical management targets and primary disease intermediate outcomes (haemoglobin A1c fraction; per cent of normal forced expiratory volume at one second; and estimated glomerular filtration rate). A total of 457 records were audited. Higher-risk alcohol consumption is associated with reduced ability of patients to reach management targets (F[3,453]=3.68; p=0.012) and decreased standardised primary disease outcome (F[3,403]=2.86; p=0.037). Higher-risk alcohol consumption is associated with reduced attainment of chronic disease management targets and worse chronic disease outcomes. Implications for public health: Alcohol consumption should be assessed frequently in people with chronic disease, especially when there is difficulty acquiring management targets or worsening of disease outcomes without a clear explanation. Better education about the potential associations between alcohol use and chronic disease would benefit those managing these complex conditions, both clinicians and patients.
Identifiants
pubmed: 33044774
doi: 10.1111/1753-6405.13017
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
451-456Informations de copyright
© 2020 The Authors.
Références
Australian Bureau of Statistics. National Health Survey: First Results 2017-18. Canberra (AUST): ABS; 2019.
Australian Institute of Health and Welfare. Australian Burden of Disease Study: Impact and Causes of Illness and Death in Australia 2011. Canberra (AUST): AIHW; 2016.
National Health and Medical Research Council. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Canberra (AUST): NHMRC; 2009.
Spangler JG, Konen JC, McGann KP. Prevalence and predictors of problem drinking among primary care diabetic patients. J Fam Pract. 1993;37(4):370-5.
Mudd J, Preston R, Larkins S. Qualitative exploration of barriers to alcohol management in patients with chronic disease in a regional setting. Aust J Prim Health. 2020;26(3):265-70.
Northern Queensland Primary Health Network. Northern Queensland PHN Health Needs Assessment. Cairns (AUST): State Government of Queensland; 2016.
Northern Queensland Primary Health Network. Northern Queensland Primary Health Network Alcohol and Other Drugs Regional Needs Assessment. Cairns (AUST): State Government of Queensland; 2017.
Abouyanni G, Stevens LJ, Harris MF, Wickes WA, Ramakrishna SS, Ta ENG, et al. GP attitudes to managing drug- and alcohol-dependent patients: A reluctant role. Drug Alcohol Rev. 2000;19(2):165-70.
Simmons LA, Wolever RQ, Bechard EM, Snyderman R. Patient engagement as a risk factor in personalized health care: A systematic review of the literature on chronic disease. Genome Med. 2014;6(2):16.
Ahmed AT, Karter AJ, Liu J. Alcohol consumption is inversely associated with adherence to diabetes self-care behaviours. Diabet Med. 2006;23(7):795-802.
Lerman I, Lozano L, Villa AR, Hernández-Jiménez S, Weinger K, Caballero AE, et al. Psychosocial factors associated with poor diabetes self-care management in a specialized center in Mexico City. Biomed Pharmacother. 2004;58(10):566-70.
Colomer-Pérez N, Chover-Sierra E, Navarro-Martínez R, Andriusevičienė V, Vlachou E, Cauli O. Alcohol and drug use in European university health science students: Relationship with self-care ability. Int J Environ Res Public Health. 2019;16(24):5042.
Coventry PA, Fisher L, Kenning C, Bee P, Bower P. Capacity, responsibility, and motivation: A critical qualitative evaluation of patient and practitioner views about barriers to self-management in people with multimorbidity. BMC Health Serv Res. 2014;14:536.
Australian Institute for Health and Welfare. Risk Factors Contributing to Chronic Disease. Catalogue No.: PHE 157. Canberra (AUST): AIHW; 2012.
Kristensen M, Guassora A, Arreskov A, Waldorff F, Holge-Hazelton B. ‘I've put diabetes completely on the shelf till the mental stuff is in place’. How patients with doctor-assessed impaired self-care percieve disease, self-care, and support from general practitioners. A qualitative study. Scand J Public Health. 2018;36(3):342-51.
The Royal Australian College of General Practitioners. General Practice Management of Type 2 Diabetes: 2016-18. Melbourne (AUST): RACGP; 2016.
Yang IA, Brown JL, George J, Jenkins S, McDonald CF, McDonald VM, et al. COPD-X Australian and New Zealand guidelines for the diagnosis and management of chronic obstructive pulmonary disease: 2017 update. Med J Aust. 2017;207(10):436-42.
Kidney Health Australia. Chronic Kidney Disease Management in General Practice. 3rd ed. Melbourne (AUST): KHA; 2015.
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789-95.
SPSS: Statistics for Windows. Version 25. Armonk (NY): IBM Corp; 2017.
Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res. 2007;31(7):1208-17.
Chew LD, Nelson KM, Young BA, Bradley KA. Association between alcohol consumption and diabetes preventive practices. Fam Med. 2005;37(8):589-94.
National Association of Diabetes Centres. Australian National Diabetes Audit. Melbourne (AUST): NADC; 2015.
Thomas P, Seale JP, Johnson JA, Dhabliwala J, Kitchens D, Okosun IS, et al. Impact of a quality improvement intervention to increase brief alcohol and drug interventions on a level 1 trauma service. Am Surg. 2016;82(5):468-73.
Ramsey SE, Engler PA. At-risk drinking among diabetic patients. Subst Abuse. 2009;3:15-23.