Screening and brief intervention for alcohol use in general practice and the potential role of digital technologies in optimising delivery
|
|
- Kerrie Rose
- 8 years ago
- Views:
Transcription
1 Presentation to Imperial College London Wednesday 10 th December 2014 Screening and brief intervention for alcohol use in general practice and the potential role of digital technologies in optimising delivery Paul Wallace Theme Director Primary Care, NIHR Clinical Research Networks Professor Primary Health Care (emeritus) General Practitioner (retired)
2 Professor of Primary Care (emeritus) GP Principal and Partner (retired) Director, NIHR Primary Care Research Network
3
4 Scope of the presentation To consider the scale of the problems due to alcohol misuse To review the role of alcohol screening and brief intervention (SBI) in general practice To consider the role of digital technologies is delivering SBI To present the international EFAR trials programme
5 Size of the problem The EU is the heaviest drinking region in the World Average per capita consumption of 12.5 litres per annum Average 3 drinks per day, and double the world average In the EU in 2004 ~ 95,000 men and ~ 25,000 women aged 15 and 64 years died of alcohol-attributable causes (11.8% of all deaths in this age category) Alcohol in EU consumption, harm and policy approaches. WHO Europe 2012
6 Alcohol is the leading risk factor for overall burden of disease among men aged DALYs lost attributable to 10 leading risk factors, for the age group years (2004) In 2004, 4.5% of the global burden of disease and injury was attributable to alcohol: 7.4% for men and 1.4% for women DALY=disability-adjusted life year WHO. Global status report on alcohol and health, 2011
7 Proportion of deaths within major disease categories attributable to alcohol in the EU for the group aged years, 2004 Alcohol in EU consumption, harm and policy approaches. WHO Europe 2012
8 Current epidemic of liver disease in the UK
9 Clinician advice for behavioural change Clinicians are well placed to provide opportunistic counselling Patients consult their GP several times each year (in UK 5) Behavioural counselling by GPs demonstrated to be cost effective for and alcohol
10 Screening and Brief Intervention (SBI) in primary care settings Largest evidence base relates to preventive interventions Mainly use of brief alcohol interventions in primary care with hazardous and harmful drinkers who are not seeking treatment (generally because they are unaware of their alcohol-related risk or harm) Delivery by a range of practitioners has beneficial effectseffect size is greater when doctors are the deliverers Comprehensive reviews conducted for the NICE concluded that alcohol SBI is a highly cost-effective strategy for health sector organisations, especially primary care NICE=National Institute of Health and Clinical Excellence Alcohol in EU consumption, harm and policy approaches. WHO Europe 2012
11 Categories of alcohol use / misuse Alcohol Harmful*/ dependence Higher risk** Hazardous* / Increasing risk** Lower risk /abstinence WHO* / DH**
12 Standard drinks (units) Medium glass of wine, % ABV = 2 250ml glass = 3 Small glass fortified wine 50ml = 1 Half pint ordinary strength beer - 3.5%. = 1 (Most lagers are 5% and = 1.5 A single measure of spirits 25ml = 1 (35ml also exists and = 1.5)
13 Screening instruments Bio-markers Questionnaires
14 Screening the AUDIT-C Questions Scoring system Your score How often do you have a drink containing alcohol? Never Monthly or less 2 4 times per month 2 3 times per week 4+ times per week How many units of alcohol do you drink on a typical day when you are drinking? How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year? Never Less than monthly Monthly Weekly Daily or almost daily Score of 3 OR More detailed assessment of drinking and related problems 6 or more drinks on one occasion Bush et al. Arch Intern Med 1998;158(16): Bradley et al. Alcohol Clin Exp Res 2007;31(7):
15 AUDIT questionnaire (Alcohol Use Disorders Test) Designed to detect harmful/hazardous drinking 10 items on consumption, symptoms and consequences of alcohol use 92% sensitivity in primary care 94% specificity in primary care Saunders JB, Aasland OG, Babor TF et Al. Addiction 1993
16 Domains and item content AUDIT Questions How often do you have a drink containing alcohol? How many units of alcohol do you drink on a typical day when you are drinking? How often have you had 6 or more units if female, or 8 or more if male, on a single occasion in the last year? How often during the last year have you found that you were not able to stop drinking once you had started? How often during the last year have you failed to do what was normally expected from you because of your drinking? How often during the last year have you needed an alcoholic drink in the morning to get yourself going after a heavy drinking session? Scoring system Never Monthly or less 2 4 times per month 2 3 times per week 4+ times per week Never Never Never Never Alcohol consumption Less than monthly Less than monthly Less than monthly Less than monthly Frequency Typical quantity Frequency of heavy drinking Monthly Monthly Monthly Weekly Dependence symptoms Weekly Impaired control Monthly Increased salience Weekly Morning drinking Weekly Daily or almost daily Daily or almost daily Daily or almost daily Daily or almost daily Your score How often during the last year have you had a feeling of guilt or remorse after drinking? How often during the last year have you been unable to remember what happened the night before because you had been drinking? Have you or somebody else been injured as a result of your drinking? Has a relative or friend, doctor, or other health worker been concerned about your drinking or suggested that you cut down? Never Never No No Less than Daily or Monthly Weekly monthly almost daily Alcohol-related problems Less than monthly Monthly Guilt after drinking Weekly Blackouts Yes, Alcohol-related but not in injuries Other last concern year about drinking Yes, but not in the last year Daily or almost daily Yes, during the last year Yes, during the last year WHO (Babor et al. AUDIT: The Alcohol Use Disorders Identification Test. Guidelines for use in primary health care.1989; Saunders et al. Addiction1993; 88(6): )
17 Delivering brief advice: NICE guidance Brief advice to be given to everyone who scores as a risky or harmful drinker: Offer a session of structured brief advice on alcohol. If this cannot be offered immediately, offer an appointment as soon as possible thereafter NICE. Alcohol-use disorders preventing the development of hazardous and harmful drinking. Public health guidance, PH24. Issued: June 2010
18 What does brief advice look like? Brief advice should take 5 15 minutes and should: Use a recognised, evidence-based resource that is based on FRAMES principles F Feedback R A M E Responsibility Advice Menu Empathy S Self-efficacy Lead to a set of goals Review and extend, if necessary Miller and Sanchez 1993
19 The Stages of Change Model Precontemplation Relapse Change maintenance Contemplation Change instigation after Prochaska and Di Clemente 1994
20 Brief advice: decisional balance sheet Positives of reducing my drinking.. Less good things about reducing my drinking Positives of not reducing. Less good things about not reducing.
21 21 Brief advice: drink diaries
22 Alcohol Learning Centre The IBA pathway Not all risky drinkers will be suitable for IBA - heavy and dependent drinkers need referral to specialist services
23
24
25
26
27
28
29
30 Conclusions: A significant reduction in weekly alcohol consumption between intervention and control conditions was demonstrated between 3 months and less than 12 months followup indicating esbi is an effective intervention. J Med Internet Res 2014;16(6):e142) doi: /jmir.3193
31 Why might digital have a place in the delivery of SBI in general practice? In primary care, <10% at risk drinkers are identified, and < 5% receive brief intervention A combination of factors are responsible for this know / do gap Lack of training and support Fear of compromising therapeutic relationship Time constraints Most people feel more secure interacting with a computer/online
32 The International EFAR trials programme Effectiveness of facilitated access to alcohol reduction websites Non inferiority RCTs of esbi vs face to face intervention Initial Italian trial developed with Piero Struzzo Subsequent multi-country study application for UK, Australia, Italy, Spain, conditionally funded by BUPA Trials in progress in Italy and Spain and in development in Australia and UK
33 Rationale for the EFAR trial Providing GP facilitated access to an alcohol reduction website for screening and brief intervention could be a promising alternative to the face-to-face brief intervention. There is growing patient access to the necessary technology by internet and/or mobile phone Evidence regarding the relative effectiveness of this approach limited.
34 What is GP facilitated access? GP facilitated access is: Active encouragement of patients by their general practitioner to access and engage with digitally mediated health interventions (internet or mobile phone)
35 GP facilitated access In the UK it is familiar to primary care and mental health professionals through the established model of providing facilitated access to computerised cognitive behavioural therapy programmes such as Beating the Blues and Fear Fighter.* * Department of Health. Improving Access to Psychological Therapies Implementation Plan: National guidelines for regional delivery. London: Department of Health; 2008.
36 Italy - the EFAR FVG project
37 EFAR: effectiveness of facilitated access to alcohol reduction websites EFAR FVG non-inferiority RCT of ebi vs face-toface intervention funded by Italian Ministry of Health run by Piero Struzzo in Friuli-Venezia- Giulia, Italy
38 BMJ Open 2013;3:e doi: /bmjopen
39 Aim of the EFAR FVG study Overall: To evaluate whether online GP facilitated access to an alcohol reduction website for at-risk drinkers is as effective as face-to-face brief intervention conducted by GPs
40 The EFAR FGV trial key features Non-inferiority randomised controlled trial Participating GPs are all in the Italian Region of Friuli Venezia Giulia (FVG) GPs role is to actively promote the use of the alcohol screening component of the health website Ti Vuoi Bene? On-line consent, assessment, randomisation and follow-up Comparison is between face to face and online intervention for risky drinkers Effect size to be excluded: 10% difference Required sample size patients per country
41 GP facilitated online recruitment via the Ti Vuoi Bene? brochure and website Active distribution by GPs of brochure with personalised log-in code Code provides access to with screening module using the AUDIT-C Cut point of 5 used to identify risky drinkers Those scoring at or above cut point invited to take part in study
42 Download your Doctor : digital generation of personal physician presence online Tailoring of messages to reflect organisational and personal identity Menu driven facility including: Photograph of GP/Practice Written messages from GP Audio/Video recorded messages option
43 Digitally mediated GP messaging with video
44 Stage1: Brochure distribution, online screening, consent, assessment, randomisation
45 Stage 2: Randomisation, follow-up and analysis
46 Where are we now? Main trial started Recruitment completed
47 EFAR FVG recruitment and follow up spread-sheet* *figures as of 7 th Nov 2014
48 Key findings from EFAR FVG Trial has recruited 753 patients GP recruitment rates variable (range 1-89 pts) ~ 50% of patients logged on after FA from their GP ~ 18% of patients screened positive ~ 90% of screen +ve patients provided consent & completed baseline assessment Majority of randomized patients either accessed online intervention or received face to face BI ~ 90% follow-up achieved at 3 months
49 Predictions.. If an appropriate balance can be identified between the use of digital and the personal engagement of the healthcare professional, it is likely that this approach will prove increasingly successful. Success will depend critically on our ability to assess the key elements contributing to both effectiveness and sustainability.
50
51 Variability in GP recruitment activity
52 Overall log-on, screening and randomisation
53 Online randomisation
54 Offer and delivery of face to face BI
55 Engagement with online intervention
56 3 month follow-up rates
Alcohol Identification and Brief Advice
Alcohol Identification and Brief Advice Alcohol Identification and Brief Advice (IBA) is an evidence based brief intervention directed at people drinking at increasing and higher risk levels who are not
More informationAUDIT. The Alcohol Use Disorders Identification Test: Interview Version
AUDIT The Alcohol Use Disorders Identification Test: Interview Version Read questions as written and record answers carefully. Begin the AUDIT by saying Now I am going to ask you some questions about your
More informationCAGE. AUDIT-C and the Full AUDIT
CAGE In the past have you ever: C tried to Cut down or Change your pattern of drinking or drug use? A been Annoyed or Angry because of others concern about your drinking or drug use? G felt Guilty about
More informationAlcohol Identification and Brief Advice (IBA) in Buckinghamshire
Alcohol Identification and Brief Advice (IBA) in Buckinghamshire A resource for frontline health and multi-agency professionals to identify and respond to alcohol consumption above recommended levels This
More informationAlcohol Risk Assessment
Alcohol Risk Assessment NHS Health Check Challenges Don Lavoie Alcohol Programme Manager What I hope to cover Why Alcohol - what is the problem? What can Health Check do about it? How do you do it? What
More informationHow To Diagnose And Treat An Alcoholic Problem
guideline for identification and treatment of alcohol abuse/dependence in primary care This guideline is informational in nature and is not intended to be a substitute for professional clinical judgment.
More informationScreening and brief intervention ABC Alcohol RNZCGP 2013
Screening and brief intervention ABC Alcohol RNZCGP 2013 John McMenamin Grateful thanks to: Health Promotion Agency Learn Online Learning for you/blueprint Objective: Screening and Brief Intervention Alcohol
More informationhttp://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx
http://nurse practitioners and physician assistants.advanceweb.com/features/articles/alcohol Abuse.aspx Alcohol Abuse By Neva K.Gulsby, PA-C, and Bonnie A. Dadig, EdD, PA-C Posted on: April 18, 2013 Excessive
More informationAlcohol Screening Questions and Guidance
Alcohol use screening tool Supporting Guidance These screening questions should be completed in relation to all young people identified as previously, currently or who are suspected of using alcohol and
More informationThe SAOR Model for Screening and Initial Assessment
The SAOR Model for Screening and Initial Assessment The key components of the SAOR model are outlined below: Support Ask & Assess Offer Assistance Refer The support aspect of the intervention is guided
More informationGP-led services for alcohol misuse: the Fresh Start Clinic
London Journal of Primary Care 2011;4:11 15 # 2011 Royal College of General Practitioners GP Commissioning GP-led services for alcohol misuse: the Fresh Start Clinic Johannes Coetzee GP Principle, Bridge
More informationPrevention and treatment of alcohol misuse
Prevention and treatment of alcohol misuse Liz Burns Public Health Development Advisor elizabeth.burns@mhsc.nhs.uk Alison Rodriguez alison.rodriguez@mhsc.nhs.uk Head of Service Community Alcohol Team and
More informationScreening and Brief Intervention for Unhealthy Alcohol and Other Drug Use in Primary Care
Screening and Brief Intervention for Unhealthy Alcohol and Other Drug Use in Primary Care Richard Saitz MD MPH FACP FASAM Professor of Medicine & Epidemiology Clinical Addiction Research and Education
More informationDoc Dial-in Discussion Series
Doc 2 Doc Dial-in Discussion Series Session 3: Universal Screening for Unhealthy Alcohol and Other Drug (AOD) Use Learning Objectives: (1) Understand the concept of universal screening (2) Learn how to
More informationDavid M Greenwell Argyll and Bute Addiction Team
Establishing a Programme of Screening and Brief Interventions for Alcohol in Primary Care Based on Sign 74 The Management of Harmful Drinking and Alcohol Dependence in Primary Care David M Greenwell Argyll
More informationLocally Enhanced Service for a practice-based Alcohol Monitoring, Withdrawal and Detoxification Service
08/09 Locally Enhanced Service for a practice-based Alcohol Monitoring, Withdrawal and Detoxification Service Reference: LES24 Contents: 1. Finance Details 2. Service Aims 3. Service Criteria 4. Ongoing
More informationDo specialist alcohol liaison nurses improve alcohol-related outcomes in patients admitted to hospital settings?
Do specialist alcohol liaison nurses improve alcohol-related outcomes in patients admitted to hospital settings? Niamh Fingleton and Catriona Matheson Academic Primary Care, University of Aberdeen, March
More informationReducing underage alcohol harm in Accident and Emergency settings
Reducing underage alcohol harm in Accident and Emergency settings The current scale of underage alcohol-related harm requires a consistent national response 36 under-18s were admitted to hospital in England
More informationAlcohol Screening and Brief Interventions of Women
Alcohol Screening and Brief Interventions of Women Competency #2 Midwest Regional Fetal Alcohol Syndrome Training Center Competency 2: Screening and Brief Interventions This competency addresses preventing
More informationAlcohol-use disorders overview
Alcohol-use disorders overview A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive and designed
More informationFamily Focused Therapy for Bipolar Disorder (Clinical Case Series) Participant Information Sheet
Family Focused Therapy for Bipolar Disorder (Clinical Case Series) Participant Information Sheet Study Title: Family Focused Therapy for Bipolar Disorder: A Clinical Case Series) We would like to invite
More informationScreening Patients for Substance Use in Your Practice Setting
Screening Patients for Substance Use in Your Practice Setting Learning Objectives By the end of this session, participants will Understand the rationale for universal screening. Identify potential health
More informationSample Script of an Initial Brief Alcohol Counseling Session
Information Sheet for Behavioral Health Providers in Primary Care Sample Script of an Initial Brief Alcohol Counseling Session Introduce the Subject with a Transitional Statement From your answers it appears
More informationSBIRT: Behavioral Health Screenings & Patient- Centered Care. Presented By: Zoe O Neill July 24, 2013
SBIRT: Behavioral Health Screenings & Patient- Centered Care Presented By: Zoe O Neill July 24, 2013 Welcome! Type questions into the Questions Pane Patient-Centered Primary Care Institute History and
More informationTraining primary care nurses to conduct alcohol screening and brief interventions in South Africa
Training primary care nurses to conduct alcohol screening and brief interventions in South Africa Karl Peltzer, Phillip Seoka, Tom Babor and Joyce Tlakula Funding: WHO & NRF South Africa Limpopo Province-Makhado
More informationChapter 7. Screening and Assessment
Chapter 7 Screening and Assessment Screening And Assessment Starting the dialogue and begin relationship Each are sizing each other up Information gathering Listening to their story Asking the questions
More informationAlcohol Overuse and Abuse
Alcohol Overuse and Abuse ACLI Medical Section CME Meeting February 23, 2015 Daniel Z. Lieberman, MD Professor and Vice Chair Department of Psychiatry George Washington University Alcohol OVERVIEW Definitions
More informationAlcohol Units. A brief guide
Alcohol Units A brief guide 1 2 Alcohol Units A brief guide Units of alcohol explained As typical glass sizes have grown and popular drinks have increased in strength over the years, the old rule of thumb
More informationFact sheet: Brief interventions and treatments for alcohol use disorders across Europe
Fact sheet: Brief interventions and treatments for alcohol use disorders across Europe December 2012 Health systems and treatment for alcohol use disorders (AUD) The provision of screening and brief interventions
More informationALCOHOL & OTHER DRUGS
ALCOHOL & OTHER DRUGS Essential Information for Social Workers A BASW Pocket Guide Produced with support from: NHS National Treatment Agency for Substance Misuse Bedford and Luton ALCOHOL, DRUGS & SOCIAL
More informationX./2.: The short intervention
X./2.: The short intervention In the course of the processing of the chapter the student gets acquainted with the field of application and the methods of short intervention X./2.1. Theoretical bases of
More informationNHS Swindon and Swindon Borough Council. Executive Summary: Adult Alcohol Needs Assessment
NHS Swindon and Swindon Borough Council Executive Summary: Adult Alcohol Needs Assessment Aim and scope The aim of this needs assessment is to identify, through analysis and the involvement of key stakeholders,
More informationSubstance Use Education for Nurses Screening, Brief Intervention and Referral to Treatment (SBIRT) SBIRT: An Effective Approach
Substance Use Education for Nurses Screening, Brief Intervention and Referral to Treatment (SBIRT) University of Pittsburgh The ATN-SBIRT Program is a partnership with the University of Pittsburgh and
More informationExcessive alcohol consumption increases the likelihood of accidental injury. This
Abstract Excessive alcohol consumption increases the likelihood of accidental injury. This pilot study reports on the prevalence of hazardous drinkers presenting to a Minor Injuries Unit. The proportion
More informationEffectiveness of Brief Alcohol Intervention strategies. Eileen Kaner
Effectiveness of Brief Alcohol Intervention strategies Eileen Kaner Professor of Public Health and Primary Care Research eileen.kaner@newcastle.ac.uk Introduction Scope of alcohol harm Preventive paradox
More informationAlcohol and Sensible Drinking
Page 1 of 5 Alcohol and Sensible Drinking See your doctor or practice nurse if you are drinking above the safe limits and are finding it difficult to cut down. What are the recommended safe limits of alcohol
More informationAlcohol and Opiates Disorders
BRIEF SCREENING, INTERVENTION, AND REFERRAL The Problem According to the National Institute on Alcohol Abuse and Alcoholism 3 in 10 adults drink at levels that elevate their risk of physical, mental health,
More informationDrinking patterns. Summary
Drinking patterns 6 Linda Ng Fat and Elizabeth Fuller Summary This chapter presents data on frequency of drinking alcohol, the amount consumed on the heaviest drinking day in the previous week, and regular
More informationFacts About Alcohol. Addiction Prevention & Treatment Services
Facts About Alcohol Addiction Prevention & Treatment Services Table of Contents Facts about alcohol: What is harmful involvement with alcohol?... 2 What is alcohol dependence?... 3 What Is BAC?... 4 What
More informationBrief Interventions for other drugs? Luke Mitcheson, Clinical Psychologist,
Brief Interventions for other drugs? Luke Mitcheson, Clinical Psychologist, Ideas in development For who? Delivered by? What? When? How to disseminate outside of specialist commissioned services? Implementation
More informationEffective Action on Alcohol Misuse: ADULTS
Effective Action on Alcohol Misuse: ADULTS Who are we? Jackie Williams, Aneurin Bevan Gwent Public Health Craig Jones, NHS Public Health Wales Dr. Paul Jordan, Cardiff University John Bradley, NHS Public
More informationImplementation of SBIRT onto Electronic Health Records: From Documentation to Data
Implementation of SBIRT onto Electronic Health Records: From Documentation to Data John R. McAteer, LCSW-R New York City Department of Health and Mental Hygiene Bureau of Alcohol and Drug Use Prevention,
More informationAlcohol-use disorders: alcohol dependence. Costing report. Implementing NICE guidance
Alcohol-use disorders: alcohol dependence Costing report Implementing NICE guidance February 2011 (February 2011) 1 of 37 NICE clinical guideline 115 This costing report accompanies the clinical guideline:
More informationEducational approaches towards tackling alcohol misuse
Educational approaches towards tackling alcohol misuse Robert Patton (May 2004) Educational interventions are designed to increase knowledge about alcohol and in doing so to change an individual s attitude
More informationAlcohol Use Disorder Identification Test Self-Report Version (AUDIT-SR)
Alcohol Use Disorder Identification Test Self-Report Version (AUDIT-SR) Questionnaire Supplement to the Study Data Tabulation Model Implementation Guide for Human Clinical Trials Prepared by TBI Standards
More informationAlcohol and Dependence
The facts about... Alcohol and Dependence Five key things you need to know A glass of wine with dinner, a beer after work, a cocktail in the sunshine on holiday. Alcohol makes an appearance in so many
More informationBRIEF INTERVENTION. For Hazardous and Harmful Drinking. Thomas F. Babor John C. Higgins-Biddle. A Manual for Use in Primary Care
WHO/MSD/MSB/01.6b Original: English Distribution: General Thomas F. Babor John C. Higgins-Biddle BRIEF INTERVENTION For Hazardous and Harmful Drinking A Manual for Use in Primary Care World Health Organization
More informationA Guide to Alcoholism and Problem Drinking
A Guide to Alcoholism and Problem Drinking Alcoholism is a word which many people use to mean alcohol dependence (alcohol addiction). Some people are problem drinkers without being dependent on alcohol.
More informationAlcoholism and Problem Drinking
Page 1 of 5 Alcoholism and Problem Drinking Alcoholism is a word which many people use to mean 'alcohol dependence' (alcohol addiction). Some people are 'problem drinkers' without being dependent on alcohol.
More informationAlcohol consumption. Summary
Alcohol consumption 6 Elizabeth Fuller Summary This chapter presents adults alcohol consumption in several ways: frequency; the maximum amount drunk on any day in the last week; and usual weekly consumption.
More informationSPECIFICATION FOR THE LOCAL COMMISSIONED SERVICE FOR THE MANAGEMENT ALCOHOL MISUSE
SPECIFICATION FOR THE LOCAL COMMISSIONED SERVICE FOR THE MANAGEMENT OF ALCOHOL MISUSE Date: March 2015 1 1. Introduction Alcohol misuse is a major public health problem in Camden with high rates of hospital
More informationAlcohol. Problems with drinking alcohol
Alcohol Alcoholism is a word which many people use to mean alcohol dependence (alcohol addiction). Some people are problem drinkers without being dependent on alcohol. If you are alcohol- dependent then
More informationAlcoholism and Problem Drinking
Page 1 of 5 Alcoholism and Problem Drinking Alcoholism is a word which many people use to mean alcohol dependence (alcohol addiction). Some people are problem drinkers without being dependent on alcohol.
More informationThe 2 nd National Emergency Department survey of Alcohol Identification and Intervention activity
The 2 nd National Emergency Department survey of Alcohol Identification and Intervention activity Final report to the funders: Alcohol Research UK April 2012 Dr Robert Patton PhD National Addiction Centre
More informationEstover Surgery New Patient Questionnaire
Date of Completion: Personal Details Title: Mr Mrs Miss Ms Dr Other (please circle) Name: Date of Birth: Mobile Number: Home Telephone Number: Work Telephone Number: Contact Email Address: Marital Status:
More informationAlcohol. Alcohol INFORMATION SHEET. Page 1 of 18
Alcohol INFORMATION SHEET Page 1 of 18 Contents Drinking problem?... 3 Units of alcohol... 3 Units and drinks... 4 Why drink?... 5 Hangovers... 6 Getting help... 7 Am I drinking too much? (AUDIT)... 9
More informationBrief Screening, Intervention, and Referral for Alcohol and Opiate Disorders. An Effective Three-Step Process. Provider Guidelines
Brief Screening, Intervention, and Referral for Alcohol and Opiate Disorders An Effective Three-Step Process Provider Guidelines The Problem According to the National Institute on Alcohol Abuse and Alcoholism,
More informationLuton Alcohol Strategy 2012-2015
Luton Drug & Alcohol Partnership Luton Alcohol Strategy 2012-2015 The Luton alcohol strategy for 2012 2015 reflects the increasing emphasis on working in partnership to reduce alcohol related harm to young
More informationAZERBAIJAN. Lower-middle Income Data source: United Nations, data range 1999-2006
AZERBAIJAN SOCIOECONOMIC CONTEXT Total population 8,406,000 Annual population growth rate 0.6% Population 15+ years 76% Adult literacy rate 98.8% Population in urban areas 52% Income group (World bank)
More informationAlcohol screening and brief intervention in primary care: no evidence of efficacy for dependence
Systematic review: Alcohol screening and brief intervention in primary care: no evidence of efficacy for dependence Richard Saitz MD, MPH, FACP, FASAM Professor of Medicine & Epidemiology Boston University
More informationTAJIKISTAN. Recorded adult (15+) alcohol consumption by type of alcoholic beverage (in % of pure alcohol), 2005
TAJIKISTAN SOCIOECONOMIC CONTEXT Total population 6,640,000 Annual population growth rate 1.3% Population 15+ years 61% Adult literacy rate 99.5% Population in urban areas 25% Income group (World bank)
More informationSeek, Test, Treat and Retain for Vulnerable Populations: Data Harmonization Measure
Seek, Test, Treat and Retain for Vulnerable Populations: Measure Drug and Alcohol Use Drug and Alcohol Measure References: 1) Adapted from: Babor, T.F., Higgins-Biddle, J.C., Saunders, J.B. & Monteiro,
More informationAlcohol, drugs and older people
Alcohol, drugs and older people This leaflet is for older people (defined as those aged 55 or over) who are worried about their use of alcohol, illegal drugs and/or prescribed/over-the-counter medications.
More informationAss Professor Frances Kay-Lambkin. NHMRC Research Fellow, National Drug and Alcohol Research Centre UNSW
Ass Professor Frances Kay-Lambkin NHMRC Research Fellow, National Drug and Alcohol Research Centre UNSW Frances Kay-Lambkin PhD National Health and Medical Research Council Research Fellow Substance Use
More informationNational Standard for Tobacco Cessation Support Programme
National Standard for Tobacco Cessation Support Programme STANDARDS DOCUMENT The development of a National Standard for Intensive Tobacco Cessation Support Services is one of the key priorities of the
More informationA PRELIMINARY EVALUATION OF SBIRT IMPLEMENTATION IN THE COLORADO STATE EMPLOYEE ASSISTANCE PROGRAM
A PRELIMINARY EVALUATION OF SBIRT IMPLEMENTATION IN THE COLORADO STATE EMPLOYEE ASSISTANCE PROGRAM DECEMBER, 2010 FOR FURTHER INFORMATION, PLEASE CONTACT: MELISSA RICHMOND, PH.D. OMNI INSTITUTE 899 LOGAN
More informationAlcohol and drugs. Introduction. The legal position
Alcohol and drugs Introduction There are no reliable figures for the misuse of drugs and alcohol by NHS staff but a survey in 2001 by Alcohol Concern and Drugscope suggested that 60 per cent of employers
More informationKarla Ramirez, LCSW Director, Outpatient Services Laurel Ridge Treatment Center
Karla Ramirez, LCSW Director, Outpatient Services Laurel Ridge Treatment Center 1 in 4 Americans will have an alcohol or drug problems at some point in their lives. The number of alcohol abusers and addicts
More informationMVP/PREFERRED CARE GUIDELINE
MVP/PREFERRED CARE GUIDELINE MVP/Preferred Care Clinical Guideline Overview Screening Adolescents for Alcohol and Substance Abuse in Primary Care MVP Health Care/ Preferred Care, as part of its continuing
More informationPlease make an appointment with the nurse for a new patient medical within one month of joining the practice.
New Patients If you are registering with us as a new patient, please be aware we will need to ask you to provide evidence of identification (ID) as part of the registration process. A combination of two
More informationPERSPECTIVES ON DRUGS The role of psychosocial interventions in drug treatment
UPDATED 4.6.2015 PERSPECTIVES ON DRUGS The role of psychosocial interventions in drug treatment Psychosocial interventions are structured psychological or social interventions used to address substance-related
More informationBarriers to treatment for alcohol dependence. Sven Andréasson INEBRIA, Rome, Sep 19, 2013
Barriers to treatment for alcohol dependence Sven Andréasson INEBRIA, Rome, Sep 19, 2013 Epidemiology: Alcohol problems in Sweden DSM IV based questions 5 7 dependence criteria 1,2 % 3 4 dependence criteria
More informationCounseling and Psychological Services, University at Albany, SUNY
Building an Evidence-based Comprehensive Prevention and Intervention Program to Address Alcohol Use Among Student-Athletes Using a Public Health Framework Brian M. Freidenberg, Ph.D., Addictive Behaviors
More informationHow to keep health risks from drinking alcohol to a low level: public consultation on proposed new guidelines
How to keep health risks from drinking alcohol to a low level: public consultation on proposed new guidelines January 2016 2 How to keep health risks from drinking alcohol to a low level: public consultation
More informationRisk of alcohol. Peter Anderson MD, MPH, PhD, FRCP Professor, Alcohol and Health, Maastricht University Netherlands. Zurich, 4 May 2011
Risk of alcohol Peter Anderson MD, MPH, PhD, FRCP Professor, Alcohol and Health, Maastricht University Netherlands Zurich, 4 May 2011 Lifetime risk of an alcoholrelated death (1/100) 16.0 14.0 12.0 10.0
More informationDual Diagnosis: Models of Care and Local Pathways AGENDA. Part one: Part two:
Slide 1 Dual Diagnosis: Models of Care and Local Pathways St. Anne s Community Services Dual Diagnosis Project Slide 2 AGENDA Part one: Models of Care. Clinical Guidelines & Evidence Base Local Care Pathways
More informationUnderstanding Coding & Reimbursement for SBI. Presented By: Jen Cohrs CPC, CPMA, CGIC Director of Educational Strategies Wisconsin Medical Society
Understanding Coding & Reimbursement for SBI Presented By: Jen Cohrs CPC, CPMA, CGIC Director of Educational Strategies Wisconsin Medical Society CPT codes, descriptions and material only are Copyright
More informationTom Freese, PhD Sherry Larkins, PhD Clayton Chau, MD (Planner) - Medical Director Behavioral Services; L.A. Care Health Plan
Tom Freese, PhD Sherry Larkins, PhD Clayton Chau, MD (Planner) - Medical Director Behavioral Services; L.A. Care Health Plan UCLA Integrated Substance Abuse Programs UCLA David Geffen School of Medicine,
More informationAlcohol Screening, Brief Intervention and Referral: A Clinical Tool
Alcohol Screening, Brief Intervention and Referral: A Clinical Tool Dr. Ryan Sommers Family Physician Medical Officer of Health, NSHA Dalhousie Family Medicine Refresher Nov 27 th 2015 Disclosures None
More informationUCLA Screening and Brief Intervention Training
UCLA Screening and Brief Intervention Training For Alcohol Reduction or Cessation Client Centered Care Western Regional Training Center on Fetal Alcohol Spectrum Disorders Materials provided through funding
More informationBrief intervention on alcohol consumption and quality of life in primary health care in Sweden
Brief intervention on alcohol consumption and quality of life in primary health care in Sweden - Is there any effect? Author: Frida Silfversparre Master Thesis in Public Health Science with Health Economics,
More informationThe concept of National guidelines for treatment of alcohol and drug problems/ dependence in Sweden 2007
The concept of National guidelines for treatment of alcohol and drug problems/ dependence in Sweden 2007 Ulf Malmström coordinator, PhD National Board of Health and Welfare Cyprus May 2009 Why establish
More informationALCOHOL in the Emergency Department. Briefing Document for Joint Committee on Health in relation to alcohol. Meeting on Wednesday 14 th December, 2011
ALCOHOL in the Emergency Department Briefing Document for Joint Committee on Health in relation to alcohol Meeting on Wednesday 14 th December, 2011 Perspective of Faculty of Liaison Psychiatry, the College
More informationStatistical Bulletin. Drinking Habits Amongst Adults, 2012. Correction. Key points:
Statistical Bulletin Drinking Habits Amongst Adults, 2012 Coverage: GB Date: 17 December 2013 Geographical Area: Region Theme: Health and Social Care Correction A minor error was found in table 11 of the
More informationProtecting and improving the nation s health. Alcohol treatment in England 2013-14
Protecting and improving the nation s health Alcohol treatment in England 2013-14 October 2014 About Public Health England Public Health England exists to protect and improve the nation s health and wellbeing,
More informationKey trends nationally and locally in relation to alcohol consumption and alcohol-related harm
Key trends nationally and locally in relation to alcohol consumption and alcohol-related harm November 2013 1 Executive Summary... 3 National trends in alcohol consumption and alcohol-related harm... 5
More informationFREQUENTLY ASKED QUESTIONS
W O R KING TO BUILD A HE A LTHY AUSTRALIA FREQUENTLY ASKED QUESTIONS www.nhmrc.gov.au National Health and Medical Research Council AUSTRALIAN GUIDELINES TO REDUCE HEALTH RISKS FROM DRINKING ALCOHOL Australian
More informationNETHERLANDS (THE) Recorded adult per capita consumption (age 15+) Last year abstainers
NETHERLANDS (THE) Recorded adult per capita consumption (age 15+) 14 12 Litres of pure alcohol 1 8 6 4 Beer Spirits Wine 2 1961 1965 1969 1973 1977 1981 1985 1989 1993 1997 21 Year Sources: FAO (Food and
More informationEmployee Benefits Report
Employee Benefits Report 1000 25th Street North Great Falls, MT 59406 (406) 727-4969 (800) 406-4097 Fax (406) 727-4979 www.bphealthmt.com Benefit Administration April 2011 Volume 9 Number 4 Increase the
More informationManagement of alcohol use within rehabilitation and recovery inpatient services Goldcrest Ward/Coral and Emerald Lodge
Management of alcohol use within rehabilitation and recovery inpatient services Goldcrest Ward/Coral and Emerald Lodge DOCUMENT CONTROL: Version: 2 Ratified by: Clinical Effectiveness Committee Date ratified:
More informationNalmefene for reducing alcohol consumption in people with alcohol dependence
Nalmefene for reducing alcohol consumption in people with alcohol dependence Issued: November 2014 guidance.nice.org.uk/ta325 NICE has accredited the process used by the Centre for Health Technology Evaluation
More informationNDLS. Alcohol and Driving
NDLS Alcohol and Driving This is an overview of the driving risks for drivers who misuse alcohol and have alcohol-dependence issues. Full guidelines are published in Sláinte agus Tiomáint: Medical Fitness
More informationALCOHOL SCREENING AND BRIEF INTERVENTIONS FOR COLLEGE STUDENTS
ALCOHOL SCREENING AND BRIEF INTERVENTIONS FOR COLLEGE STUDENTS James F. Schaus, M.D. Associate Director for Clinical Services University of Central Florida Health Services Assistant Professor of Family
More informationALCOHOL. 1300 136 588 ndss.com.au AND TYPE 1 DIABETES
ALCOHOL AND TYPE 1 DIABETES 1300 136 588 ndss.com.au The National Diabetes Services Scheme (NDSS) is an initiative of the Australian Government administered by Diabetes Australia. Contents Topic Page Introduction
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for health and social care Commissioning outcomes framework programme Briefing paper
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for health and social care Commissioning outcomes framework programme Briefing paper Quality standard topic: Alcohol dependence and harmful
More informationWORKBOOK AND SELF HELP TOOLS IS IT TIME FOR A CHANGE?
WORKBOOK AND SELF HELP TOOLS and you IS IT TIME FOR A CHANGE? and you Alcohol and you is funded by the Big Lottery Fund s Impact of Alcohol Programme. Alcohol and you is a partnership of the South Eastern
More informationAlcohol use disorders: sample chlordiazepoxide dosing regimens for use in managing alcohol withdrawal
Alcohol use disorders: sample chlordiazepoxide dosing regimens for use in managing alcohol withdrawal February 2010 NICE clinical guidelines 100 and 115 1 These sample chlordiazepoxide dosing regimens
More informationReferral To Treatment for Drug & Alcohol Part I
Referral To Treatment for Drug & Alcohol Part I Geneva Sanford, MSW, LSW, LICDC Substance Abuse Coordinator Grant Medical Center 111 S. Grant Ave, 2nd FL. Columbus, Ohio 43213 (614) 566-9863 gsanford@ohiohealth.com
More information