Do PCPs Use Laboratory Tests and the AUDIT to Screen for Unhealthy Alcohol Use?
The extent that primary care physicians use laboratory tests and the AUDIT* to assess patients’ alcohol use has not been reported. In this study, researchers surveyed all primary care physicians in Finland (n=3193) to determine use of “conventional” alcohol laboratory tests (i.e., MCV, GGT, AST, ALT),** the AUDIT, and/or CDT*** to screen for unhealthy alcohol use. Sixty-six percent of those surveyed responded and anonymously reported whether they never, occasionally, or regularly used these tests.
- Regular use of any of the 3 tests was low: 33% regularly used laboratory markers, 18% regularly used the AUDIT, and 6% regularly used CDT.
- Occasional use was more common (64%, 50%, and 38%, respectively).
The authors’ claim that “almost all respondents … used some laboratory marker to detect alcohol abuse” is an overstatement given that use was occasional and that the markers were probably obtained for other purposes. Also, the appropriateness of using laboratory tests to screen for unhealthy alcohol use is not broadly accepted. Nonetheless, the low frequency of screening with the AUDIT is disappointing (but consistent with that reported in other studies of screening questionnaires). These findings from Finland suggest once again that improving implementation of alcohol screening in primary care remains an ongoing challenge.Jeffrey H. Samet, MD, MA, MPH
**Mean corpuscular volume, gamma-glutamyltransferase, aspartate aminotransferase, alanine aminotransferase
Aalto M, Seppä K. Use of laboratory markers and the AUDIT questionnaire by primary care physicians to detect alcohol abuse by patients. Alcohol Alcohol. 2005;40(6):520–523.