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March 2, 2026Journal of Orthopaedic Reports0 citationsOpen Access

Screening Older Adults for Alcohol Use in Orthopaedic Care: Healthcare Team Perspectives, Current Practices, and Barriers

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AHAshley C. HelleUniversity of MissouriBRBryce F RizvanovicUniversity of Missouri Health SystemKRKylee RucinskiCalifornia Institute for Regenerative Medicine

Key Points

  • The study aims to assess orthopaedic healthcare professionals' perceptions and practices regarding alcohol use screening in older adults.
  • Surveyed 75 medical professionals at a university-based orthopaedic clinic.
  • Collected data on perceptions of older adult drinking and attitudes toward screening.
  • Assessed current screening practices and familiarity with validated tools.
  • Conducted thematic analysis of qualitative responses regarding barriers and supports.
  • Most participants acknowledged the impact of alcohol on orthopaedic outcomes.
  • Less than 5% reported using validated screening tools.
  • Physicians demonstrated higher screening rates than clinical or administrative staff.
  • Identified barriers included limited time, workflow constraints, and training gaps.
  • Participants suggested needs for standardized workflows and improved education.

Abstract

Alcohol use disorder (AUD) is rising among older adults at a concerning rate and is considered an emerging public health problem. Despite this, validated screening is infrequently implemented in orthopaedic settings despite evidence that alcohol use negatively affects fracture risk and postoperative outcomes. Limited knowledge, training, and workflow integration may contribute to inconsistent practices. The purpose of this study is to evaluate orthopaedic healthcare professionals’ perceptions of older adult alcohol use, current screening behaviors, familiarity with validated tools, and barriers and supports relevant to implementing evidence-based screening practices. Seventy-five medical professionals from a university-based orthopaedic clinic completed questionnaires during clinical staff meetings. Measures included perceptions of older adult drinking, attitudes toward screening, current screening practices, familiarity with validated instruments, and implementation outcomes. Open-ended items assessed barriers and needed support. Descriptive statistics summarized quantitative responses, and ANOVAs examined group differences. Two independent coders conducted thematic analysis of qualitative data. Most participants agreed that alcohol affects orthopaedic outcomes and endorsed screening older adults, but fewer than 5% reported using validated tools. Physicians reported higher screening rates than clinical or administrative staff, though overall familiarity with screeners, including older-adult-specific measures, was low. Barriers included limited time, workflow constraints, training gaps, uncertainty regarding tool selection, and variable perceptions of role relevance. Participants identified needs for standardized workflows, education, and clear referral pathways. Despite broad support for alcohol screening, validated tools are rarely used in orthopaedic practice. Addressing workflow integration, training deficits, and tool familiarity may enhance implementation, improve detection of risky alcohol use, and support better outcomes for older adult orthopaedic patients. • Alcohol use disorder is rising among older adults; validated screening is infrequently implemented in orthopaedic settings • Seventy-five medical professionals from a university-based orthopaedic clinic completed questionnaires during clinical staff meetings • Most participants agreed that alcohol affects orthopaedic outcomes and endorsed screening older adults • Fewer than 5% of participants reported using validated tools • Addressing workflow integration, training deficits, and tool usage may enhance implementation and improve detection of risky alcohol use

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Cite This Study

Helle et al. (2026) studied this question.

synapsesocial.com/papers/69a528ecf1e85e5c73bf05cbhttps://doi.org/10.1016/j.jorep.2026.100954
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