Problems encountered with opportunistic screening for alcohol‐related problems in patients attending an Accident and Emergency department

Peters, Jean; Brooker, Charlie; McCabe, Chris; Short, Neil

doi:10.1046/j.1360-0443.1998.93458914.x

Cited by 49 publications

(40 citation statements)

References 9 publications

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“…Attempts to conduct a randomised trial of brief intervention in an AED have proved difficult (Peters et al, 1998), although evidence is accumulating that brief intervention for alcohol misuse in AEDs may have clinical benefit (Longabaugh et al, 2001;Monti et al, 1999;Wright et al, 1998). In a recent study, opportunistic identification and referral to an alcohol health worker (AHW) in an AED was demonstrated to be feasible and associated with lower levels of alcohol consumption over the following year (Crawford et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of screening and referral to an alcohol health worker in alcohol misusing patients attending an accident and emergency department: A decision-making approach

Barrett

Byford

Crawford

et al. 2006

Drug and Alcohol Dependence

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Telephone: 020 7848 5091 Fax: 020 7701 7600 2 We present the cost and cost-effectiveness of referral to an alcohol health worker (AHW) and information only control in alcohol misusing patients. The study was a pragmatic randomised controlled trial conducted from April 2001 to March 2003 in an accident and emergency department (AED) in general hospital in London, England. A total of 599 adults identified as drinking hazardously according to the Paddington Alcohol Test were randomised to referral to an alcohol health worker who delivers a brief intervention (n=287) or to an information only control (n=312). Total societal costs, including health and social care costs, criminal justice costs, accommodation costs and productivity losses, and clinical measures of alcohol consumption were measured. Levels of drinking were observably lower in those referred to an AHW at twelve months follow-up and statistically significantly lower at six months followup. Total costs were not significantly different at either follow-up. Referral to AHWs in an AED produces favourable clinical outcomes and does not generate a significant increase in cost. A decision-making approach revealed that there is at least a 70% probability that referral to an AHW is more cost-effective than the information only control in reducing alcohol consumption among AED attendees with a hazardous level of drinking.3

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Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of screening and referral to an alcohol health worker in alcohol misusing patients attending an accident and emergency department: A decision-making approach

Barrett

Byford

Crawford

et al. 2006

Drug and Alcohol Dependence

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show abstract

“…(7) An early attempt to conduct a randomised trial in an A+E department was abandoned due to low levels of screening and uptake of interventions. (8) More recent studies have attempted to overcome these problems by deploying trained researchers in an A+E department to screen patients and deliver interventions. (9;10) While these studies demonstrated the efficacy of brief interventions in this setting they did not explore their effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Screening and referral for brief intervention of alcohol-misusing patients in an emergency department: a pragmatic randomised controlled trial

et al. 2004

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“…Practical problems in carrying out opportunistic screening in EDs (Peters et al, 1998) can be mitigated by audit, education and feed-back (Huntley et al, 2001), and by the use of a robust pragmatic focused screening tool, e.g. the Paddington Alcohol Test (PAT), used by ED staff themselves (Patton et al, 2004a).…”

Section: Introductionmentioning

confidence: 99%

The half-life of the ‘teachable moment’ for alcohol misusing patients in the emergency department

Williams

Brown

Patton

et al. 2005

Drug and Alcohol Dependence

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Background: To determine whether the length of time between alcohol-related attendance in the Emergency Department (ED) and follow up appointment with an Alcohol Health Worker (AHW) alters attendance rate at the AHW clinic. Methods: We examined paper and computerized records made by AHWs over a 4-year period, collecting data on the length of time between identification of alcohol misuse and the appointment with the AHW, and whether the appointment was kept. Results: There is an inverse relationship between the length of time between identification of alcohol misuse and AHW appointment and the subsequent likelihood of keeping that appointment. Conclusions: To maximise attendance rates at AHW clinics, the delay between the identification and intervention for alcohol misusing patients must be kept to a minimum, preferably giving an appointment on the same day as the attendance in the ED.

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Problems encountered with opportunistic screening for alcohol‐related problems in patients attending an Accident and Emergency department

Abstract: There is a significant need for an effective intervention in this area but considerable barriers exist to testing the efficacy of potential screening strategies and interventions.

Cited by 49 publications

References 9 publications

Cost-effectiveness of screening and referral to an alcohol health worker in alcohol misusing patients attending an accident and emergency department: A decision-making approach

Cost-effectiveness of screening and referral to an alcohol health worker in alcohol misusing patients attending an accident and emergency department: A decision-making approach

Screening and referral for brief intervention of alcohol-misusing patients in an emergency department: a pragmatic randomised controlled trial

The half-life of the ‘teachable moment’ for alcohol misusing patients in the emergency department

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