Introduction Alcohol misuse can cause significant harm to an individual’s physical and psychosocial wellbeing costing the NHS £3.5 billion/year.1Both NICE2and NCEPOD3recommend alcohol screening and appropriate referral to alcohol support services for all hospital patients.
Method 100 unselected adult medical admission proformas were prospectively analysed against NICE/NCEPOD guidance. The presence and quality of alcohol screening was compared against the AUDIT-C screening tool. Documentation on advice given and referral to alcohol support services was also recorded.
Results Of 100 admissions, 6 were directly alcohol related (4 in patients with known alcohol misuse). Overall 51% were not appropriately screened for alcohol misuse: 33% had no documented alcohol history and 18% categorised as “vague”. Only 3% of patients reported drinking above the recommended weekly amount. AUDIT-C screening (see Table 1below) on the same cohort identified 16% of patients with potentially harmful drinking (score 5+), none of whom were referred to alcohol services.
Conclusion Alcohol screening in acute medical admissions is often vague or incomplete. Potentially at risk patients are not appropriately identified and referral to alcohol services needs improvement. Abbreviated screening tools such as AUDIT-C should be used to improve the sensitivity of alcohol screening and dedicated local alcohol care pathways are needed to reduce the burden of alcohol related admissions. As a result of this audit, an alcohol awareness day was held in January 2015 to educate both patients and staff on weekly recommended intake and effective alcohol screening.
Disclosure of interest None Declared.
Lifestyle Statistics, Health and Social Care Information Centre (2014) Statistics on Alcohol: England
NICE (2010) Alcohol use disorders: preventing the development of hazardous and harmful drinking. NICE clinical guideline
NCEPOD (2013) Alcohol Related Liver Disease: Measuring the Units