Detecting young adults with alcohol use disorder in a general practice

To report the detection of alcohol use disorder in 339 general practice patients age 18-29 years over a 5 year period.

Information on alcohol use was recorded in the patient notes during clinical or screening assessment. Screening was undertaken as part of a health check which included questions on consumption, concern about use and liver function tests in selected patients. The notes of all patients in this age group were reviewed after 5 years to determine the prevalence of alcohol use disorder and the method of detection.

Information on alcohol use was recorded for 236 patients (70%), collected at a screening check for 202 patients and clinically for 34 patients. No information was recorded for 103 patients. Alcohol use was recorded for 83% of the women predominantly in association with other screening checks (cervical smears and antenatal checks). Alcohol use was recorded for 59% of the men, most of whom were screened on an opportunistic basis when attending for a consultation or linked to a clinical follow-up appointment. The criteria for alcohol use disorder was met by 16% of the men and 6% of the women whose alcohol use had been assessed either clinically or by screening. Overall, just under half of those identified with alcohol use disorder were detected by the screening programme.

Both screening and clinical detection contributed to the identification of alcohol use disorder in this age group. Women were screened more successfully than men in association with other checks. A considerable proportion of men remained unscreened and a strategy for improving detection in this group is discussed.