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.
Peters
J
J
School of Health and Related Research (ScHARR), University of Sheffield, UK.
Brooker
C
C
McCabe
C
C
Short
N
N
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