Screening for alcohol use disorder in a general practice

To report the results of screening for alcohol use disorder in 611 general practice patients aged 30-69 years over a three year period.

Patients attending a health screening appointment completed a self-administered questionnaire assessing alcohol consumption and concern about drinking, and liver function tests were arranged. Positive results were assessed and patients classified according to DSM IIIR criteria for alcohol use disorder into an alcohol abuse or dependence group. Those screening positive but not meeting criteria for alcohol use disorder were classified as at-risk drinkers.

A positive alcohol screen was confirmed in 133 patients (22%), of whom 39 met the criteria for an alcohol use disorder, the remaining 94 classified at-risk. Weekly alcohol consumption above 20 drinks for men and 15 drinks for women identified 79% of those with an alcohol use disorder increasing to 83% by the addition of information about episodic heavy drinking. The inclusion of laboratory results improved the sensitivity of the overall alcohol screen to 93%, mostly by improving detection of alcohol abuse among men. The prevalence of alcohol use disorder among the 801 patients in this practice age group over three years was 13% for men and 2.5% for women. Half of these patients were identified only as a result of the screening programme.

Screening for alcohol use disorder with items included in a health check proved very effective in this practice, identifying a significant number of previously undetected patients with alcohol abuse and dependence.