1 November 201

Call to Use Screening Tests for Alcohol Disorders

Using NICE-recommended screening tests in primary care can help ensure people with alcohol-use disorders are identified and offered appropriate treatment, according to latest research.

More than a million adults aged 16 to 65 are dependent on alcohol in England, yet around 940,000 are not receiving treatment due to healthcare professionals missing symptoms, or because specialist services are not available.

Patients who could be misusing alcohol can be identified using screening tests, which can help measure the severity of their dependence, and determine which treatment options to use.

However, new research by University College London suggests that GPs are not using these tests leading to many cases of harmful or hazardous drinking being missed.

The study compared the number of people with alcohol-use disorders reported in primary care with those reported under official figures.

The researchers found that primary care data reported 1 per cent of males and 0.5 per cent of females as higher risk drinkers. This compares with figures from the Office for National Statistics (ONS) survey, which found that 8 per cent of males and 7 per cent of females are at high risk.

Furthermore, 21 per cent of men and 31 per cent of women were reported in primary care as being either teetotal or an ex-drinker, which was almost double the number who reported no alcohol consumption in the ONS survey.

The researchers said that the use of NICE-recommended screening tests was rarely documented, and called for them to be used to improve the accurate reporting of alcohol-use disorders.

NICE recommends that GPs should routinely carry out screening as an integral part of practice. For example, discussions should take place during new patient registrations, when screening for other conditions, and when managing chronic disease or carrying out a medicine review.

GPs should complete a validated alcohol questionnaire with adults being screened. An Alcohol Use Disorders Identification Test (AUDIT) should be used to decide whether to offer a brief intervention - and if so what type - or whether to make a referral.

If time is limited, NICE recommends using an abbreviated version of the test, such as AUDIT-C, AUDIT PC, SASQ or FAST.

The researchers said: "Comparisons with a population survey suggest differences in the levels of alcohol consumption recorded in GP data, with an under-recording of alcohol-use disorders and an over-recording of no drinking in GP records in comparison with survey data.

"Practices should be encouraged to screen newly-registered patients for alcohol consumption using validated screening tests, such as the AUDIT-C or FAST, as recommended by NICE."

They concluded that alcohol-screening tests could be implemented with relatively little extra work for practices, as alcohol consumption data are already being collected for most newly registering patients.

All of NICE's recommendations on preventing and screening alcohol-use disorders, can be seen in the NICE pathway on the topic.