Opportunistic screening for alcohol use disorders in primary care: comparative study

Area of Science:

• Primary Care Medicine
• Diagnostic Tools
• Public Health

Background:

• Alcohol use disorders (AUDs) pose a significant public health challenge.
• Effective screening methods are crucial for early identification and intervention in primary care settings.
• Current screening practices may vary in efficacy and cost-effectiveness.

Purpose of the Study:

• To compare the efficacy and cost-effectiveness of different screening methods for AUDs.
• To evaluate the Alcohol Use Disorders Identification Test (AUDIT) against biochemical markers.
• To assess screening performance in an opportunistic primary care setting in the UK.

Main Methods:

• A comparative study was conducted in six general practices in South Wales.
• 194 male primary care attendees completed the AUDIT questionnaire.
• Biochemical markers (GGT, AST, %CDT, MCV) and self-reported consumption (Timeline Followback) were used for comparison.

Main Results:

• AUDIT showed significant correlations with alcohol consumption and some biochemical markers (GGT, %CDT).
• AUDIT demonstrated superior sensitivity, specificity, and positive predictive value compared to biochemical markers for various consumption levels and dependence.
• The AUDIT questionnaire proved more cost-efficient, with a lower cost per true positive.

Conclusions:

• The AUDIT questionnaire is a highly efficient and cost-effective tool for routine screening of AUDs in primary care.
• AUDIT offers a reliable and economical alternative to biochemical screening for alcohol use disorders.
• Implementation of AUDIT in opportunistic screening programs can improve early detection rates.