Screening and brief alcohol intervention in primary health care: extending the existing evidence base via the UK SIPS trial

Kaner, E. and Bland, M. and Cassidy, P. and Coulton, Simon and Deluca, P. and Drummond, C. and Gilvarry, E. and Godfrey, C. and Heather, N. and Myles, J. and Newbury-Birch, D. and Oyefeso, A. and Parrott, S. and Perryman, K. and Phillips, T. and Shenker, D. and Shepherd, J. (2010) Screening and brief alcohol intervention in primary health care: extending the existing evidence base via the UK SIPS trial. In: 33rd Annual Meeting of the Research-Society-on-Alcoholism, JUN 26-30, 2010, San Antonio, TX. (doi:https://doi.org/10.1111/j.1530-0277.2010.01211.x) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

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Official URL
http://dx.doi.org/10.1111/j.1530-0277.2010.01211.x

Abstract

There have been many trials of screening and brief alcohol intervention in primary care. Most have reported positive effects of brief intervention, in terms of reduced consumption in heavy drinkers. Despite this considerable evidence-base, key questions remain including: the applicability of the evidence to routine practice; the most efficient screening strategy; and the required intensity of brief intervention. This trial aimed to evaluate the effectiveness and costeffectiveness of different models of screening and different intensities of brief alcohol intervention in routine primary care. GPs and nurses from 24 practices across the North East, London and South East of England were recruited. Practices were randomly allocated to 1 of 3 intervention conditions: a leaflet-only control group; brief structured advice; and brief lifestyle counselling. Practices were also randomised to either universal or targeted screening and to use the modified single item (M-SASQ) or FAST screening tool. To inform the screening strategy, 190 practitioners were surveyed (prior to trial commencement) to ascertain their views on which health conditions and/or contexts were most suitable for identifying heavy drinking. This presentation focuses on screening outcomes including the efficiency of targeted or universal screening. Practitioners (n = 111) preferred targeted to universal screening (55% vs. 30%) although 15% felt that a combined approach should be used. The top 4 targeting conditions were mental health, gastrointestinal problems, hypertension and accidents (rated important by 87%, 77%, 72% and 63% of practitioners respectively). Of 2291 eligible patients, 30% (n = 900) screened positively for heavy drinking and 84% (n = 754) consented to participate in the trial. The screen conversion rate (proportion of eligible patients who screened positively) was significantly higher for targeted screening (36%) compared to universal screening (26%). Targeting also identified more heavy drinkers who were older (mean age 52 vs. 49), male (56% vs. 41%), Caucasian (83% vs. 81%) and less well educated compared to universal screening. The presentation will further examine the characteristics of patients identified by each screening strategy and the relative efficiency of the screening tools. Whilst targeted screening was preferred by practitioners and appeared to be more efficient than universal screening, key groups of patients may be missed by this strategy.

Item Type: Conference or workshop item (Paper)
Subjects: H Social Sciences > HV Social pathology. Social and public welfare > HV5001 Alcohol use and miuse
R Medicine > RA Public aspects of medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 27 Aug 2014 10:55 UTC
Last Modified: 27 Aug 2014 10:55 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/42710 (The current URI for this page, for reference purposes)
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