From data to evidence, to action: findings from a systematic review of hospital screening studies for high risk alcohol consumption.
OBJECTIVE
To conduct a systematic review of hospital alcohol screening studies to identify effective and efficient evidence-based strategies.


METHODS
Sixty-five studies (N=100,980) of alcohol problem prevalence amongst hospital patients were reviewed.


RESULTS
Prevalence of positive alcohol screens varied according to hospital location, screening tool and patient characteristics. BAC measures (26%) were nearly twice as likely (OR=1.92, p<.001) to reveal positive screens in the ED than self-reports (16%). No difference was found in prevalence of self-report positive screens between ED (16%) and ward settings (17%). Males were two to four times more likely than females to screen positive (BAC: OR=2.37, p<.001, ED self-report: OR=3.07, p<.001, ward self-report: OR=4.30, p<.001). ED patients aged 20-40 years and ward patients aged 30-50 years had the highest prevalence of positive screens.


CONCLUSIONS
Prevalence of risky or problematic drinking among hospital patients is high and warrants systematic screening and intervention. Many hospitals lack sufficient resources to undertake widespread screening programs. For optimum return on resources, it is recommended to screen males in the ED using BAC measures. Established protocols applying priority criteria and staff training can increase screening accuracy and effectiveness.
Roche
Ann M
AM
National Centre for Education and Training on Addiction, Flinders University, South Australia, GPO Box 2100, Adelaide, SA 5001, Australia. ann.roche@flinders.edu.au
Freeman
Toby
T
Skinner
Natalie
N
D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D000431:Ethanol / Q000097:blood; D019317:Evidence-Based Medicine; D005260:Female; D006748:Hospital Departments / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D018570:Risk Assessment; D014947:Wounds and Injuries / Q000453:epidemiology
D000431:Ethanol