Screening for alcohol use disorder in a general practice

Area of Science:

• General Practice
• Public Health
• Addiction Medicine

Background:

• Alcohol use disorder (AUD) is a prevalent condition often undetected in primary care settings.
• Early identification of AUD is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of a screening program for alcohol use disorder in a general practice population.
• To determine the prevalence of AUD and at-risk drinking among patients aged 30-69.

Main Methods:

• A three-year screening initiative involving 611 general practice patients aged 30-69.
• Utilized self-administered questionnaires on alcohol consumption and concern, supplemented by liver function tests.
• Classified patients based on DSM-IIIR criteria for alcohol use disorder (abuse or dependence) and identified at-risk drinkers.

Main Results:

• A positive alcohol screen was confirmed in 22% of patients; 39 met criteria for AUD, and 94 were classified as at-risk.
• High weekly alcohol consumption identified 79% of AUD cases, increasing to 83% with added episodic heavy drinking data.
• Inclusion of laboratory results boosted overall screening sensitivity to 93%, particularly for detecting alcohol abuse in men.
• The prevalence of AUD was 13% in men and 2.5% in women; half of these cases were identified solely through screening.

Conclusions:

• Screening for alcohol use disorder within routine health checks is highly effective in general practice.
• The program successfully identified a substantial number of previously undiagnosed patients with alcohol abuse and dependence.
• Integrated screening facilitates early detection and intervention for AUD in primary care settings.