Screening for Hazardous Drinking in Nursing Home Residents: Evaluating the Validity of the Current Cutoffs of the Alcohol Use Disorder Identification Test-Consumption Questions by Using Ethyl Glucuronide in Hair

Dreher-Weber, Monika; Laireiter, Anton; Kühberger, Anton; Kunz, Isabella; Yegles, Michel; Binz, Tina M.; Rumpf, Hans‐Jürgen; Hoffmann, Rainer; Praxenthaler, Verena; Lang, Siegfried; Wurst, Friedrich Martin

doi:10.1111/acer.13449

Cited by 8 publications

(30 citation statements)

References 46 publications

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“…Nevertheless, when considering only the group of drivers who admitted alcohol consumption ≥ 4 times per week, the correlation between AUDIT scores and EtG concentrations was much higher (r=0.51, p=0.009). Similar degrees of correlation were found between AUDIT scores and hair EtG concentrations by Dreher-Weber et al [22] (r= 0.361, p<0.001) in 344 nursing home residents, and by Marques et al [23] (r= 0.23, p<0.01) in 146 DUI drivers. Therefore, although in our pilot study AUDIT score was able to identify a higher number of cases with chronic consumption of alcohol, a combination of both tests would improve the detection of drivers with a chronic and probable problematic consumption of alcohol.…”

Section: Comparison Between Audit Score and Hair Analysis For Alcoholsupporting

confidence: 77%

Usefulness of hair analysis and psychological tests for identification of alcohol and drugs of abuse consumption in driving license regranting

Lendoiro

Castro

Jiménez-Morigosa

et al. 2018

Forensic Science International

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The implementation of the points-based driving license helps to change the drivers' behavior and is related to a reduction of traffic accidents and fatalities. In Spain, when a driver loses all points, the driving license is revoked, so the driver must enroll on a Driver Awareness and Re-education (DARE) course. However, at the moment offenders are not submitted to any test to confirm absence of alcohol or drugs of abuse consumption, even when 9% of Spanish drivers lose their driving license for driving under the influence (DUI). The objective of this pilot study was the comparison of the usefulness of psychological tests and hair analysis to identify those individuals with a chronic consumption of alcohol and drugs of abuse among drivers performing DARE courses. Volunteers were submitted to the AUDIT and DAST-10 tests. Also a hair sample was collected and analyzed for ethylglucuronide (EtG) (LOQ 5pg/mg) and 35 licit and illicit drugs (LOQ 5-50pg/mg) by LC-MS/MS. Sixty-one participants with a mean age of 37.2±11.6years, and mainly men (90.2%), were recruited and performed AUDIT and DAST-10 tests. All hair samples were analyzed for EtG and 17 samples for licit and illicit drugs. Mean AUDIT score was 9.6 (SD=7.5), showing a value ≥8 (indicator of hazardous and harmful alcohol use) in 52.4% of cases. Mean DAST-10 score was 2.9 (SD=3.3), but a score ≥6 was detected in 21.3% of cases (indicating drug abuse or dependence). Twenty-two samples were positive for EtG, 8 for drugs of abuse (8 cocaine, 2 opioids, 1 amphetamines, 1 cannabis), and 3 for medicines. EtG concentration (20.7-1254.1pg/mg) was higher than the Society of Hair Testing (SoHT) cut-off for chronic alcohol consumption (≥30pg/mg) in 21 cases. All positive cases for methadone and cannabis, and half of positive cases for opioids and cocaine presented higher concentrations than SoHT cut-offs for chronic consumption. Higher AUDIT score and higher EtG concentration in hair were statistically associated with declaration of alcohol consumption ≥4 times/month and with previous fine for DUI of alcohol. In addition, AUDIT scores and EtG concentration in hair had a moderate but significant Spearman correlation (r=0.331, p<0.05). The combination of psychological tests and hair analysis seems to be a promising tool to identify individuals with chronic and problematic consumption of alcohol and drugs of abuse. Moreover, their application during driving license regranting procedures could increase the effectiveness of DARE courses, reduce recidivism and improve road safety.

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Section: Comparison Between Audit Score and Hair Analysis For Alcoholsupporting

confidence: 77%

Usefulness of hair analysis and psychological tests for identification of alcohol and drugs of abuse consumption in driving license regranting

Lendoiro

Castro

Jiménez-Morigosa

et al. 2018

Forensic Science International

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“…We found the AUDIT-C to perform well in identifying hazardous drinking, with an optimal cut-off of ≥5 for men and ≥4 for women, which yielded in men sensitivity and specificity values of 76.5% and 85.3%, respectively, and in women 100% and 74.1%, respectively. Our results are not quite in line with previous studies: Dreher-Weber, M., et al [27] suggested an AUDIT-C cut-off of ≥4 (sensitivity: 0.70 and specificity: 0.83) for older men and ≥2 (sensitivity: 0.70 and specificity: 0.83) for older women to detect the consumption of ≥10 g of alcohol per day, which is a lower threshold than we adopted. These cut-offs are stricter, but are intended for nursing home residents.…”

Section: The Audit-ccontrasting

confidence: 86%

“…Secondly, it is well known that some people underestimate their alcohol intake for various reasons. This tendency might be a result of cognitive impairment [27] but may also be more likely in older adults in whom hazardous drinking might have a negative connotation [38]. Higher levels of social desirability have been reported when a situation has been judged as more unethical [39].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

“…They stated that the performance of the AUDIT was less satisfactory in this older population in comparison to a younger one, which might cast doubt on the appropriateness of the AUDIT for the screening of hazardous drinking in older adults. Considering the AUDIT-C, Dreher-Weber, M., et al [27] conducted a study on the validity of this tool among 344 nursing home residents. Their data suggested an AUDIT-C cut-off of ≥4 for men and ≥2 for women to detect a consumption of ≥10 g of alcohol per day.…”

Section: Introductionmentioning

confidence: 99%

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Validation of the AUDIT and AUDIT-C for Hazardous Drinking in Community-Dwelling Older Adults

Gils

Franck

Dierckx

et al. 2021

IJERPH

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Background: One of the best-known tools in screening for hazardous drinking is the Alcohol Use Disorders Identification Test (AUDIT) and its abbreviated form, the AUDIT-C. The aim of the present study is to determine the cut-offs of both instruments in identifying hazardous drinking in older adults. Method: A sample of 1577 older adults completed a questionnaire regarding alcohol behavior. Hazardous drinking was defined as drinking >10 units/week. Receiver operating characteristics (ROC) curves of AUDIT and AUDIT-C were calculated and cut-off scores were derived. Results: Respectively 27.3% and 12.3% of older men and women drank >10 units/week. For the AUDIT the best trade-off between sensitivity and specificity was using a cut-off of ≥5 for men and ≥4 for women, which yielded in men sensitivity and specificity values respectively of 80.7% and 81.3% and in women 100% and 71.7%, respectively. We found the AUDIT-C to perform well with an optimal cut-off of ≥5 for men and ≥4 for women, which generated in men sensitivity and specificity values respectively of 76.5% and 85.3% and in women 100% and 74.1%, respectively. Conclusion: The AUDIT-C is accurate and sufficient in screening for hazardous drinking in community-dwelling older adults if the cut-offs are tailored by gender.

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“…In their results, residents with AUDs were studied as one group and compared with residents without AUDs. However, the studies of Dreher-Weber et al (2017) and Weyerer et al (1999) show a prevalence of problematic alcohol use in residents living in RCFs, 11.3 and 3.4 per cent, respectively, which means that the focus on negative health effects specifically in residents with AUDs is a small group compared to the total population of residents living in RCFs. The focus on health was also reflected in prevalence, policies and the role of care professionals.…”

Section: Alcoholmentioning

confidence: 97%

Substance use and misuse of older adults living in residential care facilities: a scoping review from a person-centred care approach

2021

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Person-centred care (PCC) in residential care facilities (RCFs) is valuable but creates challenges for care professionals balancing involvement and a partnership approach for residents while considering the health and safety outcomes of all residents. This review evaluates what is known about the substance use and misuse of residents living in RCFs and what is important to study in future research to enhance PCC, especially in cases in which residents wish to choose unhealthy behaviours. A scoping review was conducted and exclusion criteria were set. The included papers were assessed on methodological quality using the Mixed Methods Appraisal Tool and the results were qualitatively analysed. The included papers consisted of studies regarding alcohol, tobacco and illicit drugs. The results showed that care professionals are involved in facilitating and regulating alcohol and tobacco. The focus of the included papers is on alcohol and tobacco. Five of the 16 papers assessed the residents’ perspective. This review highlights the importance of incorporating the perspectives of residents, care professionals and the organisation to enhance PCC and enable residents to make shared and well-informed decisions in dialogue with care professionals. Future research should also assess the distinction between substance use and misuse, and how this affects implementing PCC in RCFs.

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Screening for Hazardous Drinking in Nursing Home Residents: Evaluating the Validity of the Current Cutoffs of the Alcohol Use Disorder Identification Test-Consumption Questions by Using Ethyl Glucuronide in Hair

Cited by 8 publications

References 46 publications

Usefulness of hair analysis and psychological tests for identification of alcohol and drugs of abuse consumption in driving license regranting

Usefulness of hair analysis and psychological tests for identification of alcohol and drugs of abuse consumption in driving license regranting

Validation of the AUDIT and AUDIT-C for Hazardous Drinking in Community-Dwelling Older Adults

Substance use and misuse of older adults living in residential care facilities: a scoping review from a person-centred care approach

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