title: Acceptability of screening for early detection of liver disease in hazardous/harmful drinkers in primary care.
abstract: BACKGROUND
  It is estimated that one-quarter of adults in the UK drink at harmful/hazardous levels leading to increased mortality and alcohol liver disease (ALD). The Alcohol Liver Disease Detection Study (ALDDeS) aimed to test out in primary care the feasibility of alcohol misuse screening in adults, using the AUDIT questionnaire, and to assess screening harmful/hazardous alcohol users for ALD using newer non-invasive serum markers of fibrosis.
  
  
  OBJECTIVE
  To explore patients' experiences of taking part in ALDDeS and understanding of the delivery and process of screening for ALD using self-report questionnaires and feedback of liver fibrosis risk using levels of non-invasive serum markers.
  
  
  METHODS
  A nested qualitative study based in five primary care practices in the UK.
  
  
  METHODS
  From a sample of patients who were identified as drinking at harmful/hazardous levels, 30 participants were identified by maximum variation sampling for qualitative in-depth interviews. Using the principles of constant comparison the transcribed interviews were thematically analysed.
  
  
  RESULTS
  Receiving a postal AUDIT questionnaire was viewed as acceptable by participants. For some completing the AUDIT increased awareness of their hazardous alcohol use and a positive blood test indicating liver fibrosis was a catalyst for behaviour change. For others, a negative blood test result provided a licence to continue drinking at hazardous levels. A limited understanding of safe drinking and of ALD was common.
  
  
  CONCLUSIONS
  Educational and training needs of primary care professionals must be taken into account, so that patients with marker levels indicating low risk of fibrosis are correctly informed about the likely risks of continuing to drink at the same levels.
authors: University of Southampton, Primary Care and Population Sciences, Aldermoor Health Centre, Southampton. cge@soton.ac.uk
authors: Caroline
authors: C
authors: Eyles
authors: Michael
authors: M
authors: Moore
authors: Nicholas
authors: N
authors: Sheron
authors: Paul
authors: P
authors: Roderick
authors: Wendy
authors: W
authors: O'Brien
authors: Geraldine M
authors: GM
authors: Leydon
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000523:psychology*; D042241:Early Diagnosis; D005260:Female; D058006:General Practice; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000175:diagnosis* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D040242:Risk Reduction Behavior; D011795:Surveys and Questionnaires
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