The effect of alcohol consumption on clinical outcomes in regional patients with chronic disease: a retrospective chart audit.

Objective: To better understand the impact of alcohol consumption on the clinical management of chronic diseases in a regional general practice setting.

Methods: A retrospective chart audit was undertaken of individual patient records at two large group general practices in Townsville, a regional Australian city. Three common indicator chronic diseases were selected that have clear management guidelines for general practice: type 2 diabetes; chronic obstructive pulmonary disease; and chronic kidney disease. The audits were analysed using SPSS software to examine the association between alcohol consumption on acquisition of clinical management targets and primary disease intermediate outcomes (haemoglobin A1c fraction; per cent of normal forced expiratory volume at one second; and estimated glomerular filtration rate).

Results: A total of 457 records were audited. Higher-risk alcohol consumption is associated with reduced ability of patients to reach management targets (F[3,453]=3.68; p=0.012) and decreased standardised primary disease outcome (F[3,403]=2.86; p=0.037).

Conclusion: Higher-risk alcohol consumption is associated with reduced attainment of chronic disease management targets and worse chronic disease outcomes. Implications for public health: Alcohol consumption should be assessed frequently in people with chronic disease, especially when there is difficulty acquiring management targets or worsening of disease outcomes without a clear explanation. Better education about the potential associations between alcohol use and chronic disease would benefit those managing these complex conditions, both clinicians and patients.