Implementation of alcohol screening and brief interventions in cardiology: a cross-sectional study of practice in Sweden.

Abstract

Aims. To investigate rates of alcohol screening and brief interventions (SBI) in cardiology, and to examine associations between patient characteristics and the implementation of screening and brief interventions (BIs). Methods. Cross-sectional survey of cardiology patients (aged ≥18 years) in three towns/cities in Sweden (Falun, Gävle, Stockholm). Self-reported study outcomes included: (a) being screened for alcohol use and (b) receiving a BI. Covariates included sociodemographic characteristics and clinical factors. We examined associations between covariates and study outcomes using logistic regression models. Results. From a total of 1051 participants (median age = 73 years, 66% men), 54% were screened for alcohol use, mostly by doctors (48%) and nurses (40%). Odds ratios (ORs) for being screened were lower among participants aged ≥80 years (OR = 0.57, 95% confidence intervals (CI) = 0.41-0.79), relative to those aged 65-79 years, and higher among participants with overweight (OR = 1.84, 95%CI = 1.38-2.44). Of those screened, 12% received BIs. Odds ratios for receiving BIs were higher among: men (OR = 3.04, 95%CI = 1.41-6.56), current smokers (OR = 10.88, 95%CI = 3.86-30.69), and participants with hazardous drinking (OR = 5.66, 95%CI = 2.59-12.36). Conclusions. Just over half cardiology patients were screened for alcohol use. Almost two-thirds of those identified with hazardous drinking did not receive BIs. Screening and BI practices varied according to individual participant characteristics, and there was a shortfall in screening among the elderly. Findings indicate inconsistent implementation of European cardiology guidelines, which recommend universal screening, and highlight a need for improved implementation strategies.