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Research ArticleOriginal Research

Alcohol Use Disorder Treatment: The Association of Pretreatment Use and the Role of Drinking Goal

Lisa Berger, Michael Brondino, Michael Fisher, Robert Gwyther and James C. Garbutt
The Journal of the American Board of Family Medicine January 2016, 29 (1) 37-49; DOI: https://doi.org/10.3122/jabfm.2016.01.150143
Lisa Berger
From the Center for Applied Behavioral Health Research, University of Wisconsin, Milwaukee (LB, MB); the Department of Family Medicine (MF, RG), the Bowles Center for Alcohol Studies (RG, JCG), and the Department of Psychiatry (JCG), University of North Carolina at Chapel Hill.
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Michael Brondino
From the Center for Applied Behavioral Health Research, University of Wisconsin, Milwaukee (LB, MB); the Department of Family Medicine (MF, RG), the Bowles Center for Alcohol Studies (RG, JCG), and the Department of Psychiatry (JCG), University of North Carolina at Chapel Hill.
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Michael Fisher
From the Center for Applied Behavioral Health Research, University of Wisconsin, Milwaukee (LB, MB); the Department of Family Medicine (MF, RG), the Bowles Center for Alcohol Studies (RG, JCG), and the Department of Psychiatry (JCG), University of North Carolina at Chapel Hill.
MD
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Robert Gwyther
From the Center for Applied Behavioral Health Research, University of Wisconsin, Milwaukee (LB, MB); the Department of Family Medicine (MF, RG), the Bowles Center for Alcohol Studies (RG, JCG), and the Department of Psychiatry (JCG), University of North Carolina at Chapel Hill.
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James C. Garbutt
From the Center for Applied Behavioral Health Research, University of Wisconsin, Milwaukee (LB, MB); the Department of Family Medicine (MF, RG), the Bowles Center for Alcohol Studies (RG, JCG), and the Department of Psychiatry (JCG), University of North Carolina at Chapel Hill.
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Article Figures & Data

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  • Figure 1.
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    Figure 1.

    Probability of any alcohol use over time before screening by trajectory class (n = 100). Group percentages are 21% for frequent drinkers (yellow), 28.5% for nearly daily drinkers (orange), and 50.5% for consistent daily drinkers (red). The lines and markers represent the observed probability of any alcohol use among participants within each trajectory class on each day during the screening period. Dotted lines represent the predicted probability of any alcohol use among participants within each trajectory class on a given day during the screening period.

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    Figure 2.

    Pretreatment goals of reduction in alcohol use (n = 62) (A) and abstinence (n = 37) (B) by trajectory classes over time on percent days abstinent (untransformed). Error bars represent the standard deviation.

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    Figure 3.

    Pretreatment trajectory classes over time on percent heavy drinking days (untransformed; n = 100). Error bars represent the standard deviation.

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    Figure 4.

    Pretreatment goal of abstinence versus a reduction in alcohol use on percent heavy drinking days (untransformed; n = 99). Error bars represent the standard deviation. Used with permission from ref. 14. Copyright © 2013 Wiley.

Tables

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    Table 1. Sociodemographic and Clinical Characteristics of the Three Trajectory Classes at Screening (n = 100)
    Frequent Drinkers (n = 21)Nearly Daily Drinkers (n = 28)Consistent Daily Drinkers (n = 51)
    Sex*
        Male81.046.462.8
        Female19.053.637.2
    Race/ethnicity†
        Nonminority85.796.392.2
        Minority14.33.77.8
    College education*
        Yes28.639.358.8
        No71.460.741.2
    Married
        Yes61.957.166.7
        No38.142.933.3
    Current tobacco use
        Yes57.153.633.3
        No42.946.466.7
    Family history of alcoholism†
        Yes90.092.696.0
        No10.07.44.0
    Previous alcohol treatment
        Yes60.060.037.5
        No40.040.062.5
    Severity of alcohol dependence†
        Mild5.011.18.5
        Moderate95.070.468.1
        Severe0.018.523.4
    Physiological dependence*†
        Yes61.983.389.6
        No38.116.710.4
    GGT level
        High23.833.340.0
        Normal76.266.760.0
    Drinking goal*
        Abstinence50.053.623.5
        Reduction in use50.046.476.5
    Condition
        Acamprosate47.653.651.0
        Placebo52.446.449.0
    Age (years)*42.7 (7.3)47.8 (7.7)48.6 (8.0)
    Duration of alcohol use (years)24.4 (8.5)26.6 (8.1)26.5 (10.4)
    AUDIT total score23.0 (5.6)24.0 (5.9)22.4 (5.2)
    CAGE total score2.7 (1.0)3.0 (0.8)2.6 (0.7)
    CGI score2.8 (1.5)3.7 (1.5)3.5 (1.8)
    Percent days abstinent‡51.0 (8.9)26.4 (7.4)6.4 (3.0)
    Percent heavy drinking days‡42.1 (10.5)60.0 (16.2)80.0 (23.3)
    • Data are either a percentage or mean (standard deviation). All sociodemographic and clinical characteristic variables had ≤7% missing data with the exception of previous treatment, which had 28% missing data.

    • ↵* P < .05.

    • ↵† Fisher exact test.

    • ↵‡ P < .001.

    • AUDIT, Alcohol Use Disorders Identification Test; CGI, Clinical Global Impression Scale.

    • View popup
    Table 2. Growth Curve Models of Trajectory Class, Drinking Goal, and Time on Percent Days Abstinent and Percent Heavy Drinking Days (n = 100)
    VariablesPDA%HDD
    Num dfDen dfFPNum dfDen dfFP
    Trajectory class22169.75<.00122166.76<.01
    Drinking goal12165.56<.0512160.26.61
    Time128489.5<.0011284128.5<.001
    Trajectory class × drinking goal22160.02.9822160.08.92
    Trajectory class × time22844.15<.0522843.23<.05
    Drinking goal × time128411.67<.0112846.63<.05
    Trajectory class × drinking goal × time22847.54<.0122842.14.12
    • %HDD, percent heavy drinking days; PDA, percent days abstinent; Num df, numerator degrees of freedom; Den df, denominator degrees of freedom.

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The Journal of the American Board of Family     Medicine: 29 (1)
The Journal of the American Board of Family Medicine
Vol. 29, Issue 1
January-February 2016
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Alcohol Use Disorder Treatment: The Association of Pretreatment Use and the Role of Drinking Goal
Lisa Berger, Michael Brondino, Michael Fisher, Robert Gwyther, James C. Garbutt
The Journal of the American Board of Family Medicine Jan 2016, 29 (1) 37-49; DOI: 10.3122/jabfm.2016.01.150143

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Alcohol Use Disorder Treatment: The Association of Pretreatment Use and the Role of Drinking Goal
Lisa Berger, Michael Brondino, Michael Fisher, Robert Gwyther, James C. Garbutt
The Journal of the American Board of Family Medicine Jan 2016, 29 (1) 37-49; DOI: 10.3122/jabfm.2016.01.150143
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