Sensitivity analysis indicates that from both perspectives the service is very cost effective and may be cost saving .
CONCLUSIONS These results make alcohol screening and counseling one of the highest-ranking preventive services among the 25 effective services evaluated using st and ardized methods .
BACKGROUND The U.S. Preventive Services Task Force ( USPSTF ) has recommended screening and behavioral counseling interventions in primary care to reduce alcohol misuse .
This study was design ed to develop a st and ardized rating for the clinical ly preventable burden and cost effectiveness of complying with that recommendation that would allow comparisons across many recommended services .
A ten-year follow-up of older former problem drinkers: risk of relapse and implications of successfully sustained remission.
OBJECTIVE This study examines the risk , predictors of relapse and the effects of successfully sustained remission on the drinking behavior , functioning , life context , coping and help seeking of older adults who were problem drinkers earlier in life . METHOD Older former problem drinkers ( n = 447 ) were prospect ively followed for 10 years and compared to lifetime nonproblem drinkers .  RESULTS Of former problem drinkers , 31 % ( n = 141 ) died over the 10-year interval , a rate 1.6 times higher than that of lifetime nonproblem drinkers . Among surviving former problem drinkers , although relapse was relatively uncommon ( 11 % ) , a less severe drinking history , heavier baseline alcohol consumption , and lower baseline income were associated with relapse . The majority ( 63 % ) of former problem drinkers who successfully achieved sustained remission continued to drink alcohol , though at levels below those consumed by older lifetime nonproblem drinkers ( n = 339 ) . Stably remitted problem drinkers who were abstinent ( SRAs ) generally reported more severe drinking histories , greater functioning and life context deficits and more help seeking than did stably remitted problem drinkers who were nonabstinent ( SRNs ) . Although SRAs and SRNs both experienced improvements in functioning over the 10-year interval , they continued to experience financial , health-related and life context deficits relative to older lifetime nonproblem drinkers . CONCLUSIONS Results suggest there are long-term costs associated with earlier drinking problems , even when remission is maintained . Both current drinking behavior and drinking history are worth considering when making recommendations regarding older adults ' alcohol consumption
Sensitivity analysis indicates that from both perspectives the service is very cost effective and may be cost saving .
CONCLUSIONS These results make alcohol screening and counseling one of the highest-ranking preventive services among the 25 effective services evaluated using st and ardized methods .
BACKGROUND The U.S. Preventive Services Task Force ( USPSTF ) has recommended screening and behavioral counseling interventions in primary care to reduce alcohol misuse .
This study was design ed to develop a st and ardized rating for the clinical ly preventable burden and cost effectiveness of complying with that recommendation that would allow comparisons across many recommended services .