Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-11T05:03:39.207Z Has data issue: false hasContentIssue false

Screening for excessive drinkers in a Hampshire general practice

Published online by Cambridge University Press:  13 June 2014

Alistair James
Affiliation:
The Surgery, 20 Woodland Road, St Austell, PL25 4QY, England
Guy Edwards
Affiliation:
Chalybeate Hospital, Tremona Road, Southampton, S016 6UY, England

Abstract

Objectives: To identify excessive drinking in a Hampshire general practice and evaluate the usefulness of the screening tools employed. Although excessive alcohol consumption is common, only one in 10 heavy drinkers is known to their general practitioner. Early identification of such patients increases the likelihood that successful intervention will decrease their alcohol intake. Screening helps recognise excessive drinkers.

Method: Three hundred and one patients consulting their general practitioner for any reason were interviewed using a questionnaire comprising a drinking history, CAGE, and brief MAST (Michigan Alcohol Screening Test). The medical records of patients identified as drinking excessively were reviewed.

Results: Forty-eight (15.9%) patients were identified as drinking to excess. Only nine of them were known to the general practitioner. The most useful tests were the drinking history and CAGE, detecting 21 and 20 of the excessive drinkers respectively. No single test used in isolation performed adequately, but the combination of a drinking history, including enquiry about binge drinking, and the CAGE was the most productive.

Conclusion: Screening for excessive drinking by taking a simple drinking history and using the CAGE is cheap and easy to administer. Only about one in five of the patients identified in this study had information concerning excessive alcohol intake in their GP records.

Type
Brief Reports
Copyright
Copyright © Cambridge University Press 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Wilkes, E. Alcohol, the clinician and the laboratory. Update 1983; 26, 1329–34.Google Scholar
2.Ogborne, AC, Gavin, MT. Identifying and helping alcohol abusers attending general health care services. Can J Public Health 1990; 81: 307–9.Google ScholarPubMed
3.Ashworth, M, Gerada, C. ABC of Mental Health: Addiction and dependence - II: Alcohol. BMJ 1997; 315: 358–60.CrossRefGoogle ScholarPubMed
4.Rydon, P, Redman, S, Sanson-Fisher, RW, Reid, AL. Detection of alcohol-related problems in general practice. J Studies on Alcohol 1992; 53: 197202.CrossRefGoogle ScholarPubMed
5.Anderson, P. Management of alcohol problems: the role of the general practitioner. Alcohol and Alcoholism 1993; 28: 263–72.Google ScholarPubMed
6.Murray, RM. The detection and management of the alcohol abuser in general practice. In: Guy, Edwards, ed. Psychiatry in General Practice. Southampton: University of Southampton, 1981; 3143.Google Scholar
7.Poikolainen, K. Underestimation of recalled alcohol intake in relation to actual consumption. Br J Addiction 1985; 80: 215–6.CrossRefGoogle ScholarPubMed
8.The Royal Colleges Report. Alcohol and the heart in perspective: sensible limits reaffirmed. A Working Group of the Royal Colleges of Physicians, Psychiatrists and General Practitioners. J Royal Coll Physicians of London 1995; 29: 266–71.Google Scholar
9.Paton, A, Saunders, JB. Definitions. BMJ 1981; 283: 1248–50.CrossRefGoogle ScholarPubMed
10.Selzer, ML. The Michigan alcoholism screening test: the quest for a new diagnostic instrument. Am J Psychiatry 1971; 127: 16531658.CrossRefGoogle ScholarPubMed
11.Pokorny, AD, Miller, BA, Kaplan, HB. The brief MAST: a shortened version of the Michegan Alcoholism Screening Test. Am J Psychiatry 1972; 129: 342–5.CrossRefGoogle Scholar
12.Leouffre, PJ, Tempier, R, Dongier, MH. The diagnosis of alcoholism in family medicine: a pilot study of the correlation of the Michegan Alcoholism Screening Test and the level of serum gamma glutamyl transferase. CMAJ 1990; 143: 504–6.Google Scholar
13.Mayfield, D, McLeod, G, Hall, P. The CAGE questionnaire: validation of a new alcoholism screening instrument. Am J Psychiatry 1974; 131: 1121–3.CrossRefGoogle ScholarPubMed
14.King, M. At risk drinking among general practice attenders: validation of the CAGE questionnaire. Psychological Med 1986; 16: 213217.CrossRefGoogle ScholarPubMed
15.Bernadt, MW, Mumford, J, Taylor, C, Smith, B, Murray, RM. Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism. Lancet 1982; 1: 325328.CrossRefGoogle ScholarPubMed
16.King, MB. Case finding for at risk drinking in general practice: cost-benefit analysis. Psychological Med 1986; 16: 359–63.CrossRefGoogle ScholarPubMed
17.McMenamin, JP. Screening for alcohol use disorder in a general practice. New Zealand Medical J 1994; 107: 55–7.Google ScholarPubMed
18.Anderson, P. Effectiveness of general practice interventions for patients with harmful alcohol consumption. Br J General Practice 1993; 43: 386–9.Google ScholarPubMed
19.Rowland, N, Maynard, A, Beveridge, A, Kennedy, P, Wintersgill, W, Stone, W. Doctors have no time for alcohol screening. BMJ 1987; 295: 95–6.CrossRefGoogle ScholarPubMed
20.Medical Council on Alcoholism. Do not change the numbers – clarify the message. The government review of the Sensible Drinking message: a Medical Council on Alcoholism view. Alcohol and Alcoholism 1995; 30: 571–5.Google Scholar
21.Royal College of General Practitioners, Office of Population Censuses and Surveys, Department of Health. Morbidity statistics from general practice. Fourth national study 1991-1992. London: HMSO, 1995.Google Scholar
22.Wilkins, RH. The hidden alcoholic in general practice. Br J Addiction 1975; 70(supp 1): 12–7.Google ScholarPubMed
23.Cutler, SF, Wallace, PG, Haines, AP. Assessing alcohol consumption in general practice patients-a comparison between questionnaire and interview (findings of the Medical Research Council's general practice research framework study on lifestyle and health). Alcohol and Alcoholism 1988; 23: 441–50.Google Scholar
24.Godfrey, C. Lost productivity and cost to society. Addiction 1997; 92 Suppl 1: S4954.CrossRefGoogle Scholar
25.Bohn, MJ, Babor, TF, Kranzler, HR. The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings. J Studies on Alcohol 1995; 56: 423–32.CrossRefGoogle ScholarPubMed
26.Piccinelli, M, Tessari, E, Bortolomasi, M, Piasere, O, Semenzin, M, Garzotto, N, Tansella, M. Efficacy of the alcohol use disorders identification test as a screening tool for hazardous alcohol intake and related disorders in primary care: a validity study. BMJ 1997; 314: 420–4.CrossRefGoogle ScholarPubMed