Routine alcohol screening in the ED: unscreened patients have an increased risk for hazardous alcohol use

2020 ◽  
Vol 37 (4) ◽  
pp. 206-211
Author(s):  
Merel van Loon ◽  
Roos C Van der Mast ◽  
M Christien van der Linden ◽  
Floris A van Gaalen
Keyword(s):  
Risk Factors ◽  
Alcohol Use ◽  
Secondary Analysis ◽  
Routine Screening ◽  
Hazardous Alcohol Use ◽  
Related Factors ◽  
Increased Risk ◽  
Hazardous Alcohol ◽  
Hazardous Alcohol Consumption ◽  
A Prospective Study

BackgroundRoutine screening programmes for hazardous alcohol use in the ED miss large numbers of patients. We investigated whether patient-related or staff-related factors cause screening failures and whether unscreened patients are at increased risk of hazardous alcohol use.MethodsThis is a secondary analysis of a prospective study. From November 2012 to November 2013, all adult patients visiting a Dutch inner city ED were screened for hazardous alcohol consumption using the Alcohol Use Disorders Identification Test-Consumption. Reasons for failure of screening were categorised as: (A) patient is unable to cooperate (due to illness or pain, decreased consciousness or incomprehension due to intoxication, psychiatric, cognitive or neurological disorder or language barrier), (B) healthcare professional forgot to ask, (C) patient refuses cooperation and (D) screening was recently performed (<6 months ago). Presence of risk factors for hazardous alcohol use was compared between screened and unscreened patients.ResultsOf the 28 019 ED patients, 18 310 (65%) were screened and 9709 (35%) were not. In 7150 patients staff forgot to screen, whereas 2559 patients were not screened due to patient factors (2340 being unable and 219 unwilling). Patients with any of these risk factors were less likely to be screened: male sex, alcohol-related visit, any intoxication, head injury, any kind of wound and major trauma. In multivariate analysis, all these risk factors were independently associated with not being screened. Patients with at least one risk factor for hazardous alcohol use were less likely to be screened. Highest prevalence of risk factors was found in patients unable or unwilling to cooperate.ConclusionPatients who do not undergo routine screening for alcohol use at triage in the ED have an increased risk for hazardous alcohol use. These data highlight the importance of screening patients, especially those initially unwilling or unable to cooperate, at a later stage.

Unpacking Violent Behavior in Young Adulthood: The Relative Importance of Hazardous Alcohol Use

2021 ◽  
pp. 088626052110441
Author(s):  
Siobhan Lawler ◽  
Lexine Stapinski ◽  
Maree Teesson ◽  
Katrina Prior ◽  
Miguel Basto-Pereira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Alcohol Use ◽  
Young Adulthood ◽  
Violent Behavior ◽  
Well Being ◽  
Self Report ◽  
Unique Contribution ◽  
Hazardous Alcohol Use ◽  
Hazardous Alcohol

Young adulthood is an important developmental period for investigating the nature of violent behavior. This study examines the unique contribution of alcohol use to violence perpetration among young adults in the Australian community, after accounting for the influence of sociodemographic, early life, trait, and well-being influences. Cross-sectional, self-report data was collected from 507 young adults aged 18-20 years in the Australian general community via an online survey. Sequential logistic regressions examined the relative and independent contribution of adverse childhood experiences (ACEs), impulsivity, psychological distress, and hazardous alcohol use to past-year violent behavior. Results show one in eight young adults aged 18-20 (13%) reported at least one act of violent behavior in the past year, primarily assault perpetrated against another person. Sequential logistic regression identified that after controlling for other risk factors, the number of ACEs reported and hazardous alcohol use were independently and positively associated with increased odds of reporting violent behavior in young adulthood. These findings demonstrate that ACEs and hazardous alcohol use are important, independent correlates of violent behavior in young adults. While preventing early adversity is key for reducing violence in the community, this evidence suggests that it is also important to target proximal causes such as hazardous alcohol use. Increasing early and widespread access to evidence-based, trauma-informed violence-prevention programs targeting risk factors across multiple settings is critical for reducing harm and supporting young people into healthy adulthood.

scholarly journals Does providing a brief internet intervention for hazardous alcohol use to people seeking online help for depression reduce both alcohol use and depression symptoms among participants with these co-occurring disorders? Study protocol for a randomised controlled trial

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022412 ◽  
Author(s):  
John A Cunningham ◽  
Christian S Hendershot ◽  
Frances Kay-Lambkin ◽  
Clayton Neighbors ◽  
Kathleen M Griffiths ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Controlled Trial ◽  
Internet Intervention ◽  
Depression Symptoms ◽  
Hazardous Alcohol Use ◽  
Internet Interventions ◽  
Hazardous Alcohol ◽  
Hazardous Alcohol Consumption

IntroductionHazardous alcohol consumption is common among people experiencing depression, often acting to exacerbate depressive symptoms. While many people with these co-occurring disorders do not seek face-to-face treatment, they do seek help online. There are effective internet interventions that target hazardous alcohol consumption or depression separately but none that combine these online interventions without the involvement of a therapist. In order to realise the potential of internet interventions, we need to develop an evidence base supporting the efficacy of internet interventions for co-occurring depression and hazardous alcohol use without any therapist involvement. This study aims to evaluate the effects on drinking, and on depressive symptoms, of combining an internet intervention targeting hazardous alcohol consumption with one for depression.Methods and analysisA double blinded, parallel group randomised controlled trial will be used. Participants with current depression who also drink in a hazardous fashion (n=986) will be recruited for a study to ‘help improve an online intervention for depression’. Participants will be randomised either to receive an established online intervention for depression (MoodGYM) or to receive MoodGYM plus a brief internet intervention for hazardous alcohol consumption (Check Your Drinking; CYD). Participants will be contacted 3 and 6 months after receiving the interventions to assess changes in drinking and depression symptoms. It is predicted that participants receiving the CYD intervention in addition to MoodGYM will report greater postintervention reductions in alcohol consumption and depressive symptoms compared with those who received MoodGYM only. Hypothesised mediation and moderation effects will also be investigated. Using an intention-to-treat basis for the analyses, the hypotheses will be tested using a generalised linear hypothesis framework, and longitudinal analyses will use either generalised linear mixed modelling or generalised estimating equation approach where appropriate.Ethics and disseminationThis research comprises the crucial first steps in developing lower-cost and efficacious internet interventions for people suffering from depression who also drink in a hazardous fashion—promoting the widespread availability of care for those in need. This study has been approved by the standing ethics review committee of the Centre for Addiction and Mental Health, and findings will be disseminated in the form of at least one peer-reviewed article and presentations at conferences.Trial registration numberNCT03421080; Pre-results.

Social Influences, Alcohol Expectancies, and Hazardous Alcohol Use Among College Athletes

2011 ◽  
Vol 5 (1) ◽  
pp. 24-43 ◽  
Author(s):  
Janine V. Olthuis ◽  
Byron L. Zamboanga ◽  
Matthew P. Martens ◽  
Lindsay S. Ham
Keyword(s):  
College Student ◽  
Alcohol Use ◽  
Student Athletes ◽  
College Athletes ◽  
Equation Modeling ◽  
Injunctive Norms ◽  
Hazardous Alcohol Use ◽  
Increased Risk ◽  
Hazardous Alcohol ◽  
College Student Athletes

Research has shown that college student-athletes are at increased risk for hazardous alcohol use. As such, this study examined social and cognitive influences on athletes’ alcohol consumption by exploring the association between injunctive norms (parental, teammate, and coach approval) and hazardous alcohol use among college athletes, and testing whether alcohol expectancy outcomes and valuations would mediate this association. College student-athletes (n = 301; mean age = 19.4, SD = 1.3) completed self-report questionnaires assessing their drinking behaviors and perceptions of alcohol use in their social environment. Structural equation modeling revealed, in all but one case, a direct association between each of the injunctive norms variables and hazardous alcohol use. In addition, negative expectancy valuations mediated the association between teammate approval and hazardous alcohol use. Injunctive norms emerged as an important factor in student-athletes’ alcohol use. Implications for alcohol intervention programming among student-athletes are discussed.

scholarly journals Hazardous alcohol use among transwomen in a Brazilian city

2017 ◽  
Vol 33 (3) ◽  
Author(s):  
Florence Kerr-Corrêa ◽  
Francisco Marto Leal Pinheiro Júnior ◽  
Telma Alves Martins ◽  
Daniel Lucas da Conceição Costa ◽  
Raimunda Hermelinda Maia Macena ◽  
...  
Keyword(s):  
Risk Factors ◽  
Alcohol Use ◽  
Low Income ◽  
Transgender Women ◽  
Unprotected Sex ◽  
Unsafe Sex ◽  
Hazardous Alcohol Use ◽  
Lack Of Information ◽  
Hazardous Alcohol ◽  
Associated Risk Factors

Abstract: There is a lack of information about alcohol use by transgender women. We estimated the prevalence of dangerous alcohol use in the last 12 months by transgender women, who are known as travestis in Brazil, and we identified the associated risk factors. Three hundred travestis were recruited using Respondent Driving Sampling (RDS). We applied the Alcohol Use Disorders Identification Test (AUDIT). We controlled the sample by applying a weight to each interviewee. Three quarters (74.2%) of travestis were regular drinkers, half (48.7%) scored over eight in the AUDIT and 14.8% scored over 20. The risk factors for alcohol use were: aged over 24, low income and unprotected sex. The dangerous use of alcohol is prevalent among travestis. Given that this group has a greater risk of HIV infection and transmission, and that the dangerous use of alcohol was associated with unsafe sex, specific intervention strategies are required.

scholarly journals Acceptability of chronic liver disease screening in a UK primary care setting: a qualitative evaluation

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e041574 ◽  
Author(s):  
Holly Knight ◽  
David Harman ◽  
Joanne R Morling ◽  
Guruprasad Aithal ◽  
Timothy Card ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Alcohol Use ◽  
Care Setting ◽  
Primary Care Setting ◽  
Hazardous Alcohol Use ◽  
Patient Awareness ◽  
Hazardous Alcohol

ObjectivesThe increasing incidence of chronic liver disease (CLD) in the UK may be attributed to a rise in preventable risk factors, including hazardous alcohol use and type 2 diabetes. Transient elastography (TE) can rapidly stratify risk of CLD in primary care populations and provide an opportunity to raise patient awareness of risk factors.This study explores patients’ experiences of TE screening in a primary care setting. In addition, patient awareness of CLD risk is explored.Study design and settingThis study used a qualitative process evaluation of a community screening pathway for CLD (Nottingham, UK). Participants completed semistructured interviews, which were audio-recorded, transcribed verbatim and analysed thematically.ParticipantsTwenty adults were purposively recruited 6 months to 2 years after TE screening. Inclusion criteria included (1) hazardous alcohol use, (2) type 2 diabetes and/or (3) persistently elevated liver enzymes without known cause.ResultsUndergoing TE in primary care was seen as acceptable to most participants. Hazardous alcohol use was identified as the primary cause of CLD; no participants were aware of metabolic risk factors. TE improved understanding of personal risk factors and prompted contemplation of lifestyle changes across all TE stratifications. However, participants’ perceptions of risk were altered by the healthcare providers’ communication of TE scores.ConclusionsHigh acceptability of TE, regardless of the risk factor, provides strong support for inclusion of TE stratification in primary care. Findings highlight the positive impact of receiving TE on risk awareness. Future clinical iterations should improve the structure and communication of TE results to patients.

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