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JRSM Short Rep. 2013 Apr 18;4(5):2042533313476696. doi: 10.1177/2042533313476696. Print 2013 May.

An identification and brief advice programme for low-risk alcohol consumption in an acute medical setting: an implementation study.

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1
Department of Gastroenterology, Chelsea and Westminster Hospital Foundation Trust, London, UK.

Abstract

OBJECTIVES:

To implement an identification and brief advice (IBA) intervention to detect low-risk/hazardous alcohol consumption.

DESIGN:

Implementation was guided through the use of quality improvement tools and training.

SETTING:

This study was conducted over an 18-month period from April 2010 to September 2011 on a 42-bed acute medical unit at a central London acute hospital.

PARTICIPANTS:

All medical patients over the age of 18 admitted to the acute assessment unit were eligible; any patient unable to provide a medical history either through language barriers or due to illness was excluded.

MAIN OUTCOME MEASURES:

Percentage of medical patients admitted each week to the acute assessment unit who were screened for low-risk/hazardous alcohol consumption.

RESULTS:

Weekly data were analysed in time series run charts and cross-referenced to the date of educational sessions and their effect on the uptake of screening monitored. A demonstrable change in the mean percentage number of patients screened was observed in different time periods, 67.3-80.1%, following targeted teaching on the AAU.

CONCLUSIONS:

Our study demonstrates the successful use of quality improvement methodology to guide the implementation of Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), an IBA intervention, in the acute medical setting. The incorporation of the AUDIT-C into an admission document has been well accepted by the junior doctors, attaining an average (mean) of 80% of patients being screened using the tool. Targeted teaching of clinical staff involved in admitting patients appears to be the most effective method in improving uptake of IBA by junior doctors.

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