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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, and others. (2017) Screening for At-Risk Alcohol Consumption in Primary Care: A Randomized Evaluation of Screening Approaches. Alcohol and Alcoholism, 52 (3). pp. 312-317. ISSN 0735-0414. E-ISSN 1464-3502. (doi:10.1093/alcalc/agx017) (KAR id:61341)

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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.

Trial registration: Current Controlled Trials ISRCTN06145674.

Item Type: Article
DOI/Identification number: 10.1093/alcalc/agx017
Uncontrolled keywords: hypertension; alcohol drinking; mental health; primary health care; arm; public health medicine; gender; alcohol intervention; patient registration
Subjects: H Social Sciences > HM Sociology
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Simon Coulton
Date Deposited: 13 Apr 2017 09:23 UTC
Last Modified: 22 Jan 2020 04:10 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/61341 (The current URI for this page, for reference purposes)
Coulton, Simon: https://orcid.org/0000-0002-7704-3274

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