[Research on the actual conditions of alcohol dependence, the harmful use of alcohol and the optimal treatment in gastroenterological inpatients].

Abstract

Purpose: The goal of the study was to examine the status, Stages of Change and motivation, alcohol dependence, and harmful use of alcohol in gastroenterological inpatients.

Methods: We interviewed 141 gastroenterological inpatients and analyzed their medical charts. The interviews used the Alcohol Use Disorders Identification Test (AUDIT), CAGE questionnaire and questions pertaining to drinking behavior, diagnosis, self-awareness of drinking/alcohol dependency, physician instructions regarding abstinence, and Stages of Change. The proportion of patients who screened positive was calculated based on the AUDIT, CAGE and International Classification of Diseases (ICD)-10 alcohol dependence/harmful use criteria. Alcohol dependence was defined as a score >or= 15 on the AUDIT, and harmful use as 8-14 on the AUDIT or meeting ICD-10 criteria for harmful use. Patients with alcohol dependence or harmful use comprised the hazardous drinking group. Common disorders in this group and in patients in a non-drinking group were compared by Fisher exact test. Stages of Change were also determined in the hazardous drinking group and factors regarding motivation and Stages of Change were analyzed using logistic regression analysis.

Results: Of the 141 patients, 18 (12.8%) scored >or= 15 on the AUDIT, 19 (13.5%) scored L 2 on the CAGE, and 48 (34%) scored >or= 8 on the AUDIT. Among those who met the ICD-10 criteria, 16.3% had alcohol dependence and 17.7% exhibited harmful use of alcohol. Significantly, common disorders in the hazardous drinking group included liver disease, colonic diverticulitis, gout/hyperuricemia, and pancreatitis. Of the alcohol-dependent patients, 52% were in the Preparation stage. After the Contemplation stage, instructions to abstain from alcohol were the most significant motivational factor.

Conclusions: Many gastroenterological inpatients exhibited alcohol dependence and about half of these patients were able to prepare for behavioral changes related to drinking. Therefore, the gastroenterological ward may help in secondary prevention of alcohol dependence and harmful use.