Evaluation of screening and brief intervention for hazardous alcohol use integrated into clinical practice in an inner-city Emergency Department

Loon, Merel van; Gaalen, Angelique C.P. van; Linden, Christien van der; Bruijn, Carla Hagestein-De

doi:10.1097/mej.0000000000000320

Cited by 16 publications

(19 citation statements)

References 15 publications

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“…It includes emergency department or urgent care center, prescribing a medicine that interacts with alcohol, and so on [ 8 ]. Many studies have shown that brief intervention about alcohol drinking in emergency department is effective [ 9 – 12 ]. Emergency department is an important clinical place for screening at-risk drinking and conducting brief intervention.…”

Section: Introductionmentioning

confidence: 99%

Screening Test for At-Risk Drinking: Development of New Abbreviated Version of Alcohol Use Disorder Identification Test for Young and Middle-Aged Adults

Lee

Jung

Choi

2018

Emergency Medicine International

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Several abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) have been developed for use in high-volume clinical situations such as emergency departments. In this study, we developed a new abbreviated version of AUDIT called the Screening Tool for At-risk Drinking (STAD) for young and middle-aged adults, consisting of two questions that reflect the structure of the AUDIT questionnaire using data from the Korea National Health and Nutrition Examination Survey (KNHANES). To derive the abbreviated test considering AUDIT item structure, we performed confirmatory factor analysis on the 10 AUDIT questions in the Korea National Health and Nutrition Examination Survey (KNHANES) IV. To validate the new abbreviated test, we analyzed the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) on the KNHANES V-VI except for the KNHANES VI-2. Based on the two-factor structure of AUDIT, question (Q) 3 and Q7 were finally selected for STAD. In validation, AUROC was significantly wider for STAD than for AUDIT-QF, which has the same number of questions. There was no significant difference between AUDIT-C, consisting of three questions, and STAD. It can be used as a simple and reliable screening test in clinical settings.

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Section: Introductionmentioning

confidence: 99%

Screening Test for At-Risk Drinking: Development of New Abbreviated Version of Alcohol Use Disorder Identification Test for Young and Middle-Aged Adults

Lee

Jung

Choi

2018

Emergency Medicine International

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“…Studies performing SBIRT according to this approach reported a lower number of unscreened patients 20 21. Adopting narrower screening criteria may decrease costs and increase specificity, especially when the occurrence of hazardous alcohol use in the total ED patient population is low 6–8 22…”

Section: Discussionmentioning

confidence: 99%

“…The SIREN study was performed from November 2012 to November 2013 in the ED of Haaglanden Medical Centre Westeinde (HMC Westeinde) 6. The HMC Westeinde is an inner city general hospital and level I trauma centre in the Netherlands, with 50 000 ED visits annually.…”

Section: Methodsmentioning

confidence: 99%

“…In a subsequent analysis, we compared the number of patients with one or more risk factors between screened patients and patients not screened due to patient-related factors (unable and unwilling to cooperate), between screened patients and patients not screened due to staff-related factors and between screened patients and the total group of unscreened patients. The factors that were found to be predictors for a positive AUDIT-C in the SIREN study (male sex, an alcohol-related reason for the ED visit, any intoxication (including but not limited to alcohol intoxication), head injury, gastrointestinal bleeding and any kind of wound) were defined as risk factors for hazardous alcohol use in this study 6. Although the category ‘major trauma, fall from height and trunk injury’ was not independently associated with hazardous alcohol use in the SIREN study, major trauma was found to be associated with hazardous alcohol use in several other studies 10 13.…”

Section: Methodsmentioning

confidence: 99%

“…In 2017, we published a study, called the Screening and brief InteRvention for hazardous alcohol use in an inner-city Emergency department in the Netherlands (SIREN) study, in which routine screening for hazardous alcohol use was performed in all adult patients who visited the ED, using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Male sex, an alcohol-related reason for the ED visit, any intoxication (including but not limited to alcohol intoxication), head injury, gastrointestinal bleeding and any kind of wound were significant predictors for a positive AUDIT-C 6…”

Section: Introductionmentioning

confidence: 96%

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Routine alcohol screening in the ED: unscreened patients have an increased risk for hazardous alcohol use

Loon¹,

Mast²,

Linden

et al. 2020

Emerg Med J

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BackgroundRoutine screening programmes for hazardous alcohol use in the ED miss large numbers of patients. We investigated whether patient-related or staff-related factors cause screening failures and whether unscreened patients are at increased risk of hazardous alcohol use.MethodsThis is a secondary analysis of a prospective study. From November 2012 to November 2013, all adult patients visiting a Dutch inner city ED were screened for hazardous alcohol consumption using the Alcohol Use Disorders Identification Test-Consumption. Reasons for failure of screening were categorised as: (A) patient is unable to cooperate (due to illness or pain, decreased consciousness or incomprehension due to intoxication, psychiatric, cognitive or neurological disorder or language barrier), (B) healthcare professional forgot to ask, (C) patient refuses cooperation and (D) screening was recently performed (<6 months ago). Presence of risk factors for hazardous alcohol use was compared between screened and unscreened patients.ResultsOf the 28 019 ED patients, 18 310 (65%) were screened and 9709 (35%) were not. In 7150 patients staff forgot to screen, whereas 2559 patients were not screened due to patient factors (2340 being unable and 219 unwilling). Patients with any of these risk factors were less likely to be screened: male sex, alcohol-related visit, any intoxication, head injury, any kind of wound and major trauma. In multivariate analysis, all these risk factors were independently associated with not being screened. Patients with at least one risk factor for hazardous alcohol use were less likely to be screened. Highest prevalence of risk factors was found in patients unable or unwilling to cooperate.ConclusionPatients who do not undergo routine screening for alcohol use at triage in the ED have an increased risk for hazardous alcohol use. These data highlight the importance of screening patients, especially those initially unwilling or unable to cooperate, at a later stage.

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Problematic alcohol consumption in homeless Australians: A narrative review of the causes, barriers to receiving help and possible solutions

Scholes¹

2019

Health Prom J of Aust

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Issue addressed: Problematic alcohol consumption (PAC) affects one-third of homeless Australians, and it is expected that the rates will increase as the population ages.However, current policy does not recognise the importance of this problem. The aim of this narrative review was to examine the social determinants and other risk factors contributing to PAC in homeless Australians, the barriers to receiving help and possible solutions for the Australian context. Methods: PubMed and PsycINFO databases and Australian government websiteswere examined for the keywords "alcohol" and "homeless," and pertinent articles were selected for inclusion and for citation tracking of further relevant articles.

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Evaluation of screening and brief intervention for hazardous alcohol use integrated into clinical practice in an inner-city Emergency Department

Abstract: Our study shows that in a large inner-city ED, SBIRT can be implemented in daily care. Screening uncovered large numbers of patients with hazardous alcohol use and identified several risk factors. Moreover, screening and intervention appeared to be effective in reducing alcohol intake.

Cited by 16 publications

References 15 publications

Screening Test for At-Risk Drinking: Development of New Abbreviated Version of Alcohol Use Disorder Identification Test for Young and Middle-Aged Adults

Screening Test for At-Risk Drinking: Development of New Abbreviated Version of Alcohol Use Disorder Identification Test for Young and Middle-Aged Adults

Routine alcohol screening in the ED: unscreened patients have an increased risk for hazardous alcohol use

Problematic alcohol consumption in homeless Australians: A narrative review of the causes, barriers to receiving help and possible solutions

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