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Brief Alcohol Advice and Screening

Brief Alcohol Advice and Screening . Ellie Gordon . Aims of session . To introduce the idea of screening and brief alcohol advice To address the issue of stigma in relation to patient's with alcohol issues. To equip staff with skills to deliver screening and brief alcohol interventions

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Brief Alcohol Advice and Screening

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  1. Brief Alcohol Advice and Screening Ellie Gordon

  2. Aims of session • To introduce the idea of screening and brief alcohol advice • To address the issue of stigma in relation to patient's with alcohol issues. • To equip staff with skills to deliver screening and brief alcohol interventions • To outline available referral and treatment pathways

  3. why should we do this? • The view of the government is that everyone accessing primary care should be offered this form of intervention. • Why? • Alcohol misuse costs ? • Treatment saves ? To the health care system alone • Early treatment can reduce the life of alcohol issues by ? Years

  4. Health costs of alcohol misuse/or all the bad staff that alcohol does! • Peripheral neuropathy • Gastritis • Bloating • Muscle wastage • Accidents • Paranoia • Anxiety • Depression • Etc. etc. etc. etc.

  5. Health gains of treatment • Reducing alcohol intake early is associated with ? • Reduction of harm • Reduced risk of developing some long term health conditions • Reduced financial burden to health care system • Increased quality of life

  6. What has stopped me asking about alcohol before ? • Exercise –small groups • Feedback • Nerves • I’ve never done this before • Who do I ask? • Who don’t I ask?

  7. What is involved in screening for alcohol? • Different elements • Questionnaire • AUDIT • Short ten item questionnaire

  8. Exercise • The delivery of any questionnaire is eased by familiarity – so we will ask you to split into pairs and try asking your partner the AUDIT questions. • After 5? Minutes swop over • Then we will reconvene and feedback.

  9. More screening • Blood test –LFT’s • The results of these blood tests form an integral part of brief advice feedback –more later. • Semi structured interview • Manual based prompts • Basic communication skills

  10. Do I only ask these people?

  11. So now who do I ask? • Unfortunately patient’s with an alcohol problem don’t wear a sign. • Alcohol affects all people in all areas of society • Blanket screening can help to reduce the risk of stigma • It also increases the likelihood of identifying hazardous and harmful alcohol use.

  12. How can I fit this into a busy clinic? • By including alcohol screening as a core element of treatment • By normalising this intervention • The AUDIT tool can be given out as a self completion questionnaire • By linking the symptoms the patient presents with to alcohol • e.g. hypertension may be linked to excessive alcohol intake

  13. I’ve asked and now what? • Offer brief advice • Feedback • Responsibility • Advice • Menu • Empathy • Self efficacy

  14. Health Care • Brief • Opportunistic • Tailored to patient need • ‘Bite size’ pieces of information • Always within own sphere of competency • If in doubt ask for help!

  15. Hazardous drinkers • Characterised by binge drinking, regular excessive alcohol intake often linked to accidents and injuries • Advice around recommended units • Making the links between level of alcohol intake and drinking • Information about the short and long term ill effects of drinking at this level • Looking at other forms of positive reinforcement

  16. Harmful drinkers • Characterised by • Use feedback from liver function tests as an objective indicator of harms caused by alcohol. • Information about the short and long term ill effects of drinking at this level. • Discuss how current ill health is linked to alcohol intake • Help the patient to realise that reduction in alcohol intake will lead to a reduction in symptoms of ill health

  17. Dependent drinkers • Any patient who attends and is identified as suffering with a dependent alcohol problem will require specialist interventions. • Referral pathways

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