Readiness to change and reasons for intended reduction of alcohol consumption in emergency department vs. trauma population

STUDY OBJECTIVES: To identify the most common reasons for intending to cut back on alcohol, in the emergency department (ED) and trauma populations, and to determine associations between reason to cut back on alcohol and education. METHODS: Conducted retrospectively at a level one trauma center between 2008-2012. The Computerized Alcohol Screening and Intervention (CASI) database includes the patient's age, gender, language, education level, Alcohol Use Disorders Identification Test (AUDIT) score(1-40), readiness to change score(1-10), and selected “Reasons to cut back” on their alcohol consumption. RESULTS: From an original 10,537 patients, 1202 met study criteria(848 ED, 354 trauma). Overall, the most common reasons for reducing alcohol were “To avoid health problems”(68.5%), “To avoid a DUI”(43.6%), "To save money"(42.0%), and "To avoid getting hurt"(41.0%). Trauma patients cited the following reasons significantly more than ED patients: “To avoid getting hurt" (46.3% vs. 38.8%, respectively), "To be in control of my behavior"(40.7% vs. 32.2%), and "My partner or spouse wants me to stop"(20.1% vs. 15.0%). Additionally, those patients who cited "To avoid health problems" reported 1.2 points higher than average (p<0.001) on the readiness to change scale. Those who have completed some college cited “To avoid health problems” less often than high school graduates(OR 0.45), while they cited “To avoid getting hurt”(OR 2.5) and “To avoid being in a car crash caused by alcohol use”(OR 3.8) more often than high school graduates. CONCLUSION: Health, injury, finances, and legal issues remain top concerns for patients, while trauma patients had proportionately more concerns with getting injured.