Article Text
Abstract
Introduction Deaths from alcoholic liver disease have increased dramatically. Currently, 24% of UK adults are said to drink in a harmful or hazardous manner. The government strategy to combat alcohol mortality (NICE PH24)1 includes widespread screening using validated questionnaires such as AUDIT (Alcohol Use Disorders Identification Test).2 Previous studies in hospitals have been with selected patients & and it is not clear how many patients in hospital are high risk drinkers. We performed a “snap shot” study of all inpatients at a single hospital on a single day using the AUDIT questionnaire to assess prevalence of high risk drinking and the feasibility of such widespread screening.
Methods All adult inpatients on a single day at Peterborough City Hospital were asked to participate. Two consultants, a nurse specialist and 30 clinical medical students used the AUDIT questionnaire to assess patients for harmful, hazardous or dependent drinking. The AUDIT questionnaire consists of 10 questions with a maximum score of 40. A score of 0–7 indicates low risk, 8–15 indicates harmful drinking, 16–19 indicates hazardous drinking and >20 indicates dependent drinking. Patients scoring >8 were then offered a brief intervention.
Results Of a total of 490 patients, AUDIT scores were obtained on 380 (78%); 110 (22%) could not be assessed because of confusion or illness. The age range was 17–99 years (mean 69). Scores ranged from 0/40 to 38/40. Of 380 inpatients who were assessed, 40 (10.5%) scored > or equal to 8/40 indicating harmful, hazardous or dependent drinking. 1.6% (6/380) scored >20 (dependent drinking), 7.4% (28/380) scored 16–19 (hazardous drinking) and 1.6% (6/380) scored 8–15 (harmful drinking). 89.5% (340/380) were low risk (score 0–7). Patients at risk (scoring 8 or above) were distributed across hospital wards and included 17% of females on the maternity ward, 13% on an orthopaedic ward and 12% on the respiratory ward.
Conclusion We have demonstrated that 10.5% of adult hospital inpatients are drinking in a harmful, hazardous or dependent manner. They were scattered throughout the hospital and not in any particular speciality. This prevalence is lower than the 24% in the UK population, perhaps due to the higher age of hospital patients. 22% of patients could not be assessed on the day of the study. However, our results suggest that the AUDIT questionnaire is a useful tool to identify patients at risk of alcohol related problems and is a feasible undertaking.
Competing interests None declared.
References 1. NICE Public Health Guidance 24:Alcohol-Use Disorders: Preventing Harmful Drinking. 2010.
2. Saunders JB, Aasland OG, Babor TF, et al. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption.11. Addiction 1993;88:791–804.