Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.
On July 18, 2024, we reported on findings from a study published in JAMA Network Open that examined the effects of a preventive intervention for alcohol use among youths with a chronic medical condition (CMC).
The study
Investigators conducted the prespecified secondary analysis of a parallel randomized controlled trial in which 451 adolescents aged 14 to 18 years (mean age, 16 years; 50.8% women) with a CMC—such as type 1 diabetes, juvenile idiopathic arthritis, or inflammatory bowel disease—and at high, low, or no risk for alcohol use were assigned to a treatment-as-usual (TAU) group or a preventive intervention, titled “Take Good Care (TGC),” between May 11, 2017, and November 20, 2018. For the purpose of the study, high-risk alcohol use was defined as heavy episodic alcohol use in the past 3 months and alcohol-related blackouts, injuries, vomiting, or emergency department visits in the previous 12 months.
The TGC intervention, conducted in clinic waiting rooms, included a deck of 28 to 32 slides on alcohol-related topics “identified in formative research as important to youths with a CMC and motivating for health-protecting decisions and behaviors,” researchers wrote. “Biomedical content within the TGC intervention was tailored to each disease area and addressed the specific effects of alcohol use on disease processes, treatment safety, and efficacy.”
The primary outcome was self-reported frequency of alcohol use over the past 3 months, measured via a single validated question. In addition, investigators assessed 2 secondary outcomes: alcohol health risk knowledge and alcohol-risk intolerance.
Among the 451 participants, 410 went on to participate in the 12-month follow-up. At baseline, 52 participants reported high-risk alcohol use and 399 reported no or low-risk use.
The findings
Results showed that among those who reported high-risk alcohol use at baseline, the observed mean frequency of alcohol use from baseline to the 12-month follow-up decreased in the intervention group from 6.3 to 4.9 days, or by 40%, and increased in the treatment-as-usual group from 5.5 to 9 days (adjusted relative rate ratio 0.6, 95% CI 0.38-0.94).
Researchers also reported there were no group differences in changes in alcohol use frequency over time among participants who reported no or low-risk alcohol use.
Authors' comment
"The intervention reduced alcohol use among medically vulnerable youths reporting high-risk use, underscoring the value of using personalized prevention strategies and investigating effect heterogeneities over long periods."
