Publicado

2023-04-01

Factors associated with the intention to reduce alcohol consumption among people who drink at risky levels in a university hospital in Bogotá D.C., Colombia

Factores asociados a la intención de disminuir el consumo de alcohol en personas con consumo riesgoso en un hospital universitario de Bogotá D.C., Colombia

Palabras clave:

Alcohol Drinking, Health Risk Factors, Hospital medicine, Primary prevention (en)
Consumo de bebidas alcohólicas, Conductas de riesgo para la salud, Atención hospitalaria, Prevención primaria (es)

Autores/as

  • Virginia Cuevas Pontificia Universidad Javeriana - Facultad de Medicina - Departamento de Medicina Preventiva y Social - Bogotá D.C. - Colombia. | Hospital Universitario de San Ignacio – Servicio de Consulta Externa - Bogotá D.C. - Colombia. https://orcid.org/0000-0003-0701-4969
  • Maylin Peñaloza Pontificia Universidad Javeriana - Facultad de Medicina - Departamento de Medicina Preventiva y Social - Bogotá D.C. - Colombia. | Hospital Universitario de San Ignacio – Centro Javeriano de Oncología - Bogotá D.C. - Colombia. https://orcid.org/0000-0002-4129-2340
  • Peter Olejua Hospital Universitario de San Ignacio - Oficina de Investigaciones - Bogotá D.C. - Colombia. https://orcid.org/0000-0002-2478-0908
  • Lina Olaya Pontificia Universidad Javeriana - Facultad de Medicina - Departamento de Medicina Preventiva y Social - Bogotá D.C. - Colombia. | Hospital Universitario de San Ignacio – Servicio de Consulta Externa - Bogotá D.C. - Colombia. https://orcid.org/0000-0003-2572-0138
  • Ingrid Almonacid Pontificia Universidad Javeriana - Facultad de Medicina - Departamento de Medicina Preventiva y Social - Bogotá D.C. - Colombia. | Hospital Universitario de San Ignacio – Servicio de Consulta Externa - Bogotá D.C. - Colombia. https://orcid.org/0000-0002-3297-4892
  • Luz Helena Alba Pontificia Universidad Javeriana - Facultad de Medicina - Departamento de Medicina Preventiva y Social - Bogotá D.C. - Colombia. | Hospital Universitario de San Ignacio – Servicio de Consulta Externa - Bogotá D.C. - Colombia. https://orcid.org/0000-0002-6186-7842

Introduction: Interventions to reduce risky alcohol use are a priority in all clinical settings, including the hospital setting.

Objectives: To describe the sociodemographic, family, and clinical characteristics of people who drink at risky levels in a university hospital, and to evaluate the association between these factors and their intention to reduce alcohol use, measured according to the stage of behavioral change they are at, which is referred to in this study as “intention to change”.

Materials and methods: Descriptive cross-sectional study conducted in 176 patients between 19 and 64 years-old classified as risky drinkers (according to AUDIT score) who underwent a surgical or a diagnostic procedure in a quaternary care hospital in Bogotá, Colombia, between April 2018 and March 2020. Bivariate (chi-square) and multivariate (ordinal logistic regression) analyses were performed to evaluate associations between independent variables (sociodemographic, family, clinical, and alcohol use-related characteristics) and intention to change. Adjusted odds ratios (aOR) were calculated, and a significance level of p<0.05 was considered.

Results: The prevalence of risky alcohol use was 4.88% (95%CI: 4.17-5.58) (176/3 609). Most participants were male (82.95%), over 30 years old (71.02%), and in the “preparation” stage of behavior change (63.63%). In the multivariate analysis, being older than 30 years was associated with a greater intention to change (31-45 years: aOR=3.68; 95%CI:1.56-9.06; 46-64 years: aOR=2.63; 95%CI:1.20-5.86), while having a high socioeconomic level was associated with a lower intention to change (aOR=0.06; 95%CI:0.01-0.50).

Conclusions. A greater intention to reduce alcohol use was observed in individuals over 30 years of age, as well as in those with a greater perception of the benefits of such reduction, those with a better perception of self-efficacy, and patients with previous attempts to reduce their alcohol use. In contrast, having a high socioeconomic level was associated with a lower intention to change.

Introducción. Las intervenciones para reducir el consumo riesgoso de alcohol son una prioridad en todos los escenarios clínicos, incluido el hospitalario.

Objetivos. Describir las características sociodemográficas, familiares y clínicas en personas con consumo riesgoso de alcohol en un hospital universitario y evaluar la asociación entre estos factores y la intención de disminuir el consumo, medida según la etapa de cambio comportamental y denominada en este estudio como “intención de cambio”.

Materiales y métodos. Estudio descriptivo transversal realizado en 176 pacientes entre 19 y 64 años con consumo riesgoso de alcohol (según puntaje AUDIT) sometidos a una intervención quirúrgica o procedimiento diagnóstico entre abril de 2018 y marzo de 2020 en un hospital de cuarto nivel de Bogotá, Colombia. Se realizó un análisis bivariado (Chi-cuadrado) y uno multivariado (regresión logística ordinal) para evaluar las asociaciones entre las variables independientes (características sociodemográficas, familiares, clínicas y relacionadas con el consumo de alcohol) y la intención de cambio. Se calcularon Odds Ratio ajustados (ORa) y se consideró un nivel de significancia de p<0.05

Resultados. La prevalencia de consumo riesgoso de alcohol fue de 4.88% (IC95%: 4.17-5.58) (176/3 609). La mayoría de participantes eran hombres (82.95%), tenían más de 30 años (71.02%) y estaban en la etapa “preparación” de cambio comportamental (63.63%). En el análisis multivariado, ser mayor de 30 años se asoció con mayor intención de cambio (31-45 años: ORa=3.68, IC95%:1.56-9.06; 46-64 años: ORa=2.63; IC95%: 1.20-5.86) y, por el contrario, ser de un estrato socioeconómico alto se asoció con menor intención (ORa=0.06; IC95%: 0.01-0.50).

Conclusiones. Se observó una mayor intención de disminuir el consumo de alcohol en los participantes mayores de 30 años, aquellos con mayor percepción de los beneficios de dicha disminución, aquellos con mayor percepción de autoeficacia, y en los pacientes con intentos previos de disminución; en contraposición, el estrato socioeconómico alto se asoció con menor intención de cambio.

Descargas

Los datos de descargas todavía no están disponibles.

Citas

O’Connor EA, Perdue LA, Senger CA, Rushkin M, Patnode CD, Bean SI, et al. Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2018;320(18):1910-28. https://doi.org/gmgkdf.

U.S. Department of Health and Human Services and U.S. Department of Agriculture (USDA). Appendix 9. Alcohol. In: 2015-2020 Dietary Guidelines for Americans. 8th ed. Washington: USDA; 2015.

World Health Organization (WHO). Global status report on alcohol and health 2018. Geneva: WHO; 2018.

National Institute on Alcohol Abuse and Alcoholism (NIAAA). Helping Patients Who Drink Too Much: A Clinician’s Guide. Updated 2005 Edition. NIAAA; 2007.

World Health Organization (WHO). Alcohol Use. Geneva: WHO; 2016.

Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of Excessive Alcohol Consumption to Deaths and Years of Potential Life Lost in the United States. Prev Chronic Dis. 2014;11:E109. https://doi.org/f6mqrp.

Centers for Disease Control and Prevention (CDC). Morbidity and Mortality Weekly Report. MMWR. 2013;62(Suppl 3).

de la Espriella-Guerrero RA, Rodriguez V, Rincón CJ, Cabrera-Morales D, Pérez-Rodríguez SJ, Gómez-Restrepo C. Consumo de alcohol en la población colombiana. Encuesta Nacional de Salud Mental 2015. Rev Colomb Psiquiatr. 2016;45(Suppl 1):76-88. https://doi.org/gm29vm.

Kaner EF, Beyer FR, Muirhead C, Campbell F, Pienaar ED, Bertholet N, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2018;2(2):CD004148. https://doi.org/cnv5.

Moyer A, Finney J. Brief interventions for alcohol misuse. CMAJ. 2015;187(7):502-6. https://doi.org/kkwp.

Ghosh A, Singh P, Das N, Pandit PM, Das S, Sarkar S. Efficacy of brief intervention for harmful and hazardous alcohol use: a systematic review and meta-analysis of studies from low middle-income countries. Addiction. 2022;117(3):545-58. https://doi.org/kkwq.

Egholm JW, Pedersen B, Møller AM, Adami J, Juhl CB, Tønnesen H. Perioperative alcohol cessation intervention for postoperative complications. Cochrane Database Syst Rev. 20188;11(11):CD008343. https://doi.org/ggkmzq.

Almonacid I, Olaya L, Cuevas V, Castillo JS, Becerra N, Delgado J, et al. Efectividad de la consejería breve en el ámbito hospitalario para la cesación del tabaquismo y la disminución del consumo riesgoso de alcohol: Protocolo de un experimento clínico aleatorizado. Rev. Colomb. Psiquiatr. 2020;51(2):146-52. https://doi.org/jcc7.

Babor TF, Higgins-Biddle JC, Saunders JR, Monteiro MG. AUDIT: Cuestionario de Identificación de los Trastornos debidos al Consumo de Alcohol. Pautas para su utilización en Atención Primaria. Ginebra: Organización Mundial de la Salud; 2001 [cited 2023 Jul 24]. Available from: https://bit.ly/3pV6jeq.

Raihan N, Cogburn M. Stages of Change Theory. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2023. [cited 2023 Jul 24]. Available from: https://bit.ly/43Dbf5s.

Bellón-Saameño JA, Delgado-Sánchez A, Luna del Castillo JD, Lardelli-Claret P. Validez y fiabilidad del cuestionario de función familiar Apgar-familiar. Aten Primaria. 1996;18(6):289-96.

Rodríguez-Martos A, Rubio G, Aubà J, Santo-Domingo J, Torralba L, Campillo M. Readiness to change questionnaire: Reliability Study of its spanish version. Alcohol Alcohol. 2000;35(3):270-5. https://doi.org/cdwqjm.

Patridge EF, Bardyn TP. Research electronic data capture (REDCap). JMLA. 2018;106(1):142-4. https://doi.org/gpckbc.

World Medical Association (WMA). WMA Declaration of Helsinki – Ethical principles for medical research involving human subjects. Fortaleza: 64th WMA General Assembly; 2013.

Colombia. Ministerio de Salud. Resolución 8430 de 1993 (octubre 4): Por la cual se establecen las normas científicas, técnicas y administrativas para la investigación en salud. Bogotá D.C.; october 4, 1993 [cited 2020 Oct 30]. Available from: https://bit.ly/31gu7do.

Karno MP, Rawson R, Rogers B, Spear S, Grella C, Mooney L, et al. Effect of Screening, Brief Intervention and Referral to Treatment for Unhealthy Alcohol and Other Drug Use in Mental Health Treatment Settings: A Randomised Controlled Trial. Addiction. 2021;116(1):159-69. https://doi.org/gn756x.

Beyer FR, Campbell F, Bertholet N, Daeppen JB, Saunders JB, Pienaar ED, et al. The Cochrane 2018 Review on Brief Interventions in Primary Care for Hazardous and Harmful Alcohol Consumption: A Distillation for Clinicians and Policy Makers. Alcohol Alcohol. 2019;54(4):417-27. https://doi.org/kkzd.

Im SC, Lee DH. Effects of screening and brief intervention on alcohol consumption in an emergency department. Clin Exp Emerg Med. 2020;7(4):310-8. https://doi.org/kkzf.

Soares J, de Vargas D. Group Brief Intervention: effectiveness in motivation to change alcohol intake. Rev Bras Enferm. 2020;73(1):e20180138. https://doi.org/gmd8pq.

Ministerio de Justicia y del Derecho, Observatorio de Drogas de Colombia (ODC). Estudio Nacional de Consumo de Sustancias Psicoactivas Colombia. Bogotá D.C.: ODC; 2019. [cited 2023 Jul 24]. Available from: https://bit.ly/3XZfN4L.

Caetano R, Vaeth PA, Canino G. Family cohesion and pride, drinking and alcohol use disorder in Puerto Rico. Am J Drug Alcohol Abuse. 2017;43(1):87-94. https://doi.org/kkzg.

Elkins C. Effects of Alcoholism on Families. Orlando. FL: DrugRehab.com; 2018 [cited 2023 Jul 24]. Available from: https://bit.ly/3OtOwnK.

Umberson D, Thomeer MB. Family Matters: Research on Family Ties and Health, 2010 to 2020. J Marriage Fam. 2020;82(1):404-19. https://doi.org/gghf5p.

Suárez C, Del Moral G, Martínez B, John B, Musitu G. El patrón de consumo de alcohol en adultos desde la perspectiva de los adolescentes. Gac Sanit. 2016;30(1):11-7. https://doi.org/f3hfc8.

Heim D, Monk RL, Qureshi AW. An examination of the extent to which drinking motives and problem alcohol consumption vary as a function of deprivation, gender and age. Drug Alcohol Rev. 2021;40(5):817-25. https://doi.org/kkzh.

Pennay A, Holmes J, Törrönen J, Livingston M, Kraus L, Room R. Researching the decline in adolescent drinking: The need for a global and generational approach. Drug Alcohol Rev. 2018;37(Suppl 1):S115-9. https://doi.org/gd8t97.

Organización Mundial de la Salud (OMS). Informe sobre la situación mundial del alcohol y la salud 2018. Resumen. Washington D.C.: OMS; 2018.

Quillas-Benites RK, Vásquez-Valencia C, Cuba-Fuentes MS. Promoción de cambios de comportamiento hacia estilos de vida saludable en la consulta ambulatoria. Acta Med Peru. 2017;34(2):126-31.

Kruger ES, Serier KN, Pfund RA, McKay JR, Witkiewitz K. Integrative data analysis of self-efficacy in 4 clinical trials for alcohol use disorder. Alcohol Clin Exp Res. 2021;45(11):2347-56. https://doi.org/gnpf9q.

Ehret PJ, Sherman DK. Integrating Self-Affirmation and Implementation Intentions: Effects on College Student Drinking. Ann Behav Med. 2018;52(8):633-44. https://doi.org/kkzj.

Scott JL, Brown AC, Phair JK, Westland JN, Schüz B. Self-affirmation, intentions and alcohol consumption in students: A randomized exploratory trial. Alcohol Alcohol. 2013;48(4):458-63. https://doi.org/f42jn9.

Kumar S, Srivastava M, Srivastava M, Yadav JS, Prakash S. Effect of Motivational Enhancement Therapy (MET) on the self efficacy of Individuals of Alcohol dependence. J Family Med Prim Care. 2021;10(1):367-72. https://doi.org/kkzk.