Different Methods of Early Identification of Risky Drinking: A Review of Clinical Signs

Abstract

From a public health perspective, there is a lack of evidence that non-systematic or semi-systematic methods can substitute systematic screening in terms of numbers of risky drinkers detected. If early signs are going to be used to identify risky drinkers, or those to be screened for risky drinking, more focus should be on psychological and social signs because they appear earlier than somatic signs.

When general practitioners talk about Alcohol: Exploring facilitating and hampering factors for pragmatic case finding

“…Most of the participants' stories on alcohol were in line with pragmatic case finding. Hence, increasing GPs' knowledge on the multitude of clinical situations where alcohol can be relevant, both causally and as a complicating factor, may be an easily adaptable strategy to increase identification of risky or harmful drinking [11].…”

Can routine information from electronic patient records predict a future diagnosis of alcohol use disorder?

“…[ 14 , 24 , 35 ] Such changes are late effects of too high alcohol consumption, and many psychosocial problems may occur much earlier. [ 15 , 36 ] We found low estimate for ICPC-2 diagnoses, perhaps because this is a composite variable, composed by converted diagnoses from ICD-10,[ 3 , 4 ] pragmatic case finding,[ 14 ] and early clinical signs [ 15 ] (Appendix A).…”

“…[ 14–16 ] Health incidents or changes in the patient’s life are used as indicators of potential relevance for addressing alcohol. These have been coined as pragmatic case finding [ 14 ] or semi-systematic method,[ 15 ] they not only focus primarily on clinical signs, but also focus on targeted screening in some routine situations. These strategies focus on the present clinical situation and the awareness that alcohol may be relevant for a patient’s health, both as a possible cause and as a complicating factor for their health problems.…”

“…We included other ICPC-2-diagnoses where there is evidence of a potential causal relation with alcohol consumption. [ 15 , 21 , 22 ] See Appendix A for all diagnoses used as predictor events. Other predictors were number of new sick leaves, non-narcotic controlled substances (class B-drugs in Norway) and elevated blood levels for GGT and MCV.…”

Do alcohol-attributable diagnoses reflect current hazardous drinking patterns in Norwegian hospital patients?

“…These factors may include for example caput medusa, spider nevi, ascites, insomnia, legal and family problems, patient demography, socio-economic factors etc. However, there is still lack of evidence that such a semi-systematic approach can substitute systematic screening in terms of numbers of risky drinkers detected (17).…”