Article Figures & Data
Tables
- Table 1.
Demographic and Clinical Characteristics by Depression Screening Status among Primary Care Adult Patients Screened for Hazardous Alcohol Use
Characteristic No. (%) P value No. (%) P value Administered the PHQ-9 Not Administered the PHQ-9 Met Criteria for Significant Depression Did Not Meet Criteria for Significant Depression Totals (n = 68,686)* (n = 2,826,220)* (n = 32,390)† (n = 36,296)† Sex <.001 <.001 Female 45,007 (65.5) 1,505,142 (53.3) 21,715 (67.0) 23,292 (64.2) Male 23,679 (34.5) 1,321,078 (46.7) 10,675 (33.0) 13,004 (35.8) Age, years <.001 <.001 18 to 39 32,295 (47.0) 1,081,490 (38.3) 17,017 (52.5) 15,278 (42.1) 40 to 65 27,980 (40.8) 1,213,142 (42.9) 12,546 (38.7) 15,434 (42.5) >65 8,411 (12.2) 531,588 (18.8) 2,827 (8.7) 5,584 (15.4) Race/ethnicity‡ <.001 <.001 Asian 6,619 (9.6) 525,505 (18.6) 3,169 (9.8) 3,450 (9.5) Black/African American 4,348 (6.3) 200,530 (7.1) 2,525 (7.8) 1,823 (5.0) Hispanic 14,194 (20.7) 554,523 (19.6) 7,425 (22.9) 6,769 (18.7) White 39,035 (56.8) 1,351,540 (47.8) 17,013 (52.5) 22,022 (60.7) Other/Unknown 4,490 (6.5) 194,122 (6.9) 2,258 (7.0) 2,232 (6.2) Medicaid coverage <.001 <.001 Yes 1,066 (1.6) 29,347 (1.0) 632 (2.0) 434 (1.2) No 67,620 (98.4) 2,796,873 (99.0) 31,758 (98.0) 35,862 (98.8) Nondepressive/non-SUD mental health diagnosis§ <.001 .751 Yes 4,628 (6.7) 138,773 (4.9) 2,172 (6.7) 2,456 (6.8) No 64,058 (93.3) 2,687,447 (95.1) 30,218 (93.3) 33,840 (93.2) Charlson comorbidity score, mean (SD) 0.29 (0.95) 0.41 (1.15) <.001 0.27 (0.91) 0.31 (0.98) <.001 Weekly alcohol use ‖ <.001 <.001 Abstinent 45,468 (66.2) 1,949,582 (69.0) 22,069 (68.1) 23,399 (64.5) Moderate alcohol use** 19,189 (27.9) 764,294 (27.0) 8,275 (25.6) 10,914 (30.1) Hazardous alcohol use†† 4,029 (5.9) 112,344 (4.0) 2,046 (6.3) 1,983 (5.5) PHQ-9, Patient Health Questionnaire 9; SUD, substance use disorder; ICD-9, International Classification of Diseases, ninth revision; SD, standard deviation.
↵* Data were restricted to the first PHQ-9 administration within 30 days following the first Alcohol Drinking as a Vital Sign primary care visit within the study period.
↵† Among patients who were administered the PHQ-9 (n = 68,686).
↵‡ Race/ethnicity data were self-reported by patients during their intake evaluation.
↵§ Any ICD-9 visit diagnosis code within 1 year prior to the first Alcohol Drinking as a Vital Sign primary care visit that adhered to the following criteria was considered a positive diagnosis: any mental, behavioral and neurodevelopmental disorder (290.XX, 293.XX, 294.XX-302.9, or 306.XX-319), excluding depressive disorders (296.2X, 296.3X, 296.82, 298.0, 300.4, 301.12, 309.0, 309.1, 309.28, or 311), alcohol-related mental disorders (291.XX, 305.0X, or 303.0X), drug-induced mental disorders (292.XX), and nontobacco drug abuse or dependence (305.2X, 305.3X, 305.4X, 305.5X, 306.6X, 305.7X, 305.8X, 305.9X, or 304.XX), where “X” represents any positive integer.
↵‖ Patients were asked to estimate alcohol use within the past 90 days.
↵** 1 to 7 drinks/week for all woman and men ages >65 years and 1 to 14 drinks/week for men ≤65 years.
↵†† ≥8 drinks/week for all woman and men ages >65 years and ≥15 drinks/week for men ≤65 years.
- Table 2.
Adjusted Odds Ratios of Depression Screening Administration and Significant Depression among Primary Care Adult Patients Screened for Hazardous Alcohol Use*
Characteristic OR (95% CI) P value OR (95% CI) P value Administered the PHQ-9 Significant Depressive Symptoms† Female (reference group, male) 1.67 (1.59 to 1.75) <.001 1.11 (1.06 to 1.17) <.001 Age, years (reference group, 18 to 39) 40 to 65 0.77 (0.73 to 0.81) <.001 0.75 (0.72 to 0.78) <.001 >65 0.51 (0.45 to 0.57) <.001 0.47 (0.43 to 0.51) <.001 Race/ethnicity (reference group, White)‡ Asian 0.45 (0.42 to 0.48) <.001 1.07 (0.98 to 1.16) .113 Black/African American 0.75 (0.69 to 0.80) <.001 1.55 (1.38 to 1.75) <.001 Hispanic 0.82 (0.78 to 0.87) <.001 1.29 (1.20 to 1.40) <.001 Other/Unknown 0.78 (0.75 to 0.81) <.001 1.21 (1.13 to 1.30) <.001 Medicaid coverage 1.25 (1.15 to 1.36) <.001 1.31 (1.15 to 1.48) <.001 Nondepressive/non-SUD mental health diagnosis§ 1.32 (1.26 to 1.39) <.001 0.96 (0.90 to 1.03) .310 Charlson comorbidity score‖ 0.96 (0.94 to 0.98) <.001 1.03 (1.01 to 1.06) .003 Weekly alcohol use (reference group: hazardous alcohol use)** Abstinent 0.72 (0.67 to 0.77) <.001 0.84 (0.78 to 0.90) <.001 Moderate alcohol use†† 0.70 (0.67 to 0.74) <.001 0.71 (0.66 to 0.76) <.001 CI, confidence interval; OR, odds ratio; PHQ-9, Patient Health Questionnaire 9; SUD, substance use disorder; ICD-9, International Classification of Diseases, ninth revision.
↵* Logistic generalized estimating equations accounting for patient nested within facility were applied to estimate population-level average effects.
↵† Among patients who were administered the PHQ-9 (n = 68,686).
↵‡ Race/ethnicity data were self-reported by patients during their intake evaluation.
↵§ Any ICD-9 visit diagnosis code within 1 year prior to the first Alcohol Drinking as a Vital Sign primary care visit that adhered to the following criteria was considered a positive diagnosis: any mental, behavioral and neurodevelopmental disorder (290.XX, 293.XX, 294.XX-302.9, or 306.XX-319), excluding depressive disorders (296.2X, 296.3X, 296.82, 298.0, 300.4, 301.12, 309.0, 309.1, 309.28, or 311), alcohol-related mental disorders (291.XX, 305.0X, or 303.0X), drug-induced mental disorders (292.XX), and nontobacco drug abuse or dependence (305.2X, 305.3X, 305.4X, 305.5X, 306.6X, 305.7X, 305.8X, 305.9X, or 304.XX), where “X” represents any positive integer.
↵‖ ORs correspond to a 1-point increment in the Charlson comorbidity score.
↵** Patients were asked to estimate alcohol use within the past 90 days; hazardous alcohol use was defined as ≥8 drinks/week for all woman and men ages >65 years and ≥15 drinks/week for men ≤65 years.
↵†† 1 to 7 drinks/week for all woman and men ages >65 years and 1 to 14 drinks/week for men ≤65 years.
