Problems encountered with opportunistic screening for alcohol-related problems in patients attending an accident and emergency department.
OBJECTIVE
To assess the value of opportunistic screening in Accident and Emergency (A&E) for patients with alcohol-related problems and provision of an intervention.


METHODS
Screening of A&E attendees for the purpose of recruitment to a randomized trial of a counselling intervention.


METHODS
A General Hospital A&E department.


METHODS
All 17,000 adult A&E attendees, during a 6-month period and all nursing staff working within the department.


METHODS
Patients' self-reported alcohol consumption, responses to the CAGE questionnaire (four questions designed to identify problem drinking) and proportions offered, and taking up offer of help.


RESULTS
Only 4663 (28%) adult attendees at A&E were actually screened and of these 2% declined and 25% were judged unable to answer. Of the rest, 86% drank alcohol, with 22% drinking in excess of current guidelines or with two or more positive answers to CAGE. Only 41% (264) of those drinking to excess were offered help and 88% of these declined it. This left 13 patients to be included in the trial.


CONCLUSIONS
There is a significant need for an effective intervention in this area but considerable barriers exist to testing the efficacy of potential screening strategies and interventions.
School of Health and Related Research (ScHARR), University of Sheffield, UK.
J
J
Peters
C
C
Brooker
C
C
McCabe
N
N
Short
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000175:diagnosis* / Q000628:therapy; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011795:Surveys and Questionnaires