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Screening for at-risk alcohol consumption in primary care: a randomized evaluation of screening approaches

Coulton, Simon; Dale, Veronica; Deluca, Paolo; Gilvarry, Eilish; Godfrey, Christine; Kaner, Eileen; McGovern, Ruth; Newbury-Birch, Dorothy; Patton, Robert; Parrott, Steve; Perryman, Katherine; Phillips, Thomas; Shepherd, Jonathan; Drummond, Colin

Authors

Simon Coulton

Veronica Dale

Paolo Deluca

Eilish Gilvarry

Christine Godfrey

Eileen Kaner

Ruth McGovern

Dorothy Newbury-Birch

Robert Patton

Steve Parrott

Katherine Perryman

Jonathan Shepherd

Colin Drummond



Abstract

Aims: The aim of the study was to explore the relative efficiency and effectiveness of targeted versus universal screening for at-risk alcohol use in a primary care population in the UK.Methods: The study was a randomized evaluation of screening approach (targeted versus universal) for consecutive attendees at primary care aged 18 years or more. Targeted screening involved screening any patient attending with one of the targeted presentations, conditions associated with excessive alcohol consumption: mental health, gastrointestinal, hypertension, minor injuries or a new patient registration. In the universal arm of the study all presentations in the recruitment period were included. Universal screening included all patients presenting to allocated practices.Results: A total of 3562 potential participants were approached. The odds ratio of being screen positive was higher for the targeted group versus the universal group. Yet the vast majority of those screening positive in the universal group of the study would have been missed by a targeted approach. A combination of age and gender was a more efficient approach than targeting by clinical condition or context.Conclusions: While screening targeted by age and gender is more efficient than universal screening, targeting by clinical condition or presentation is not. Further universal screening is more effective in identifying the full range of patients who could benefit from brief alcohol interventions, and would therefore have greater public health impact.

Journal Article Type Article
Publication Date 2017-05
Journal Alcohol and Alcoholism
Print ISSN 0735-0414
Electronic ISSN 1464-3502
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 52
Issue 3
Pages 312-317
APA6 Citation Coulton, S., Dale, V., Deluca, P., Gilvarry, E., Godfrey, C., Kaner, E., …Drummond, C. (2017). Screening for at-risk alcohol consumption in primary care: a randomized evaluation of screening approaches. Alcohol and Alcoholism, 52(3), 312-317. https://doi.org/10.1093/alcalc/agx017
DOI https://doi.org/10.1093/alcalc/agx017
Keywords Hypertension; Alcohol drinking; Mental health; Primary health care; Arm; Public health medicine; Gender; Alcohol intervention; Patient registration
Publisher URL https://academic.oup.com/alcalc/article/52/3/312/3084486
Related Public URLs https://kar.kent.ac.uk/61341/
Copyright Statement ©2018 University of Hull

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