Clare MD Hutchison, D.Keshani

Introduction

High alcohol intake is linked to a wide range of adverse health effects including cancer. Screening patients is a valuable tool in identifying patients who can benefit from intervention. Action from clinicians such as brief advice and appropriate referrals have been shown to aid patient reduction of alcohol intake. Therefore, clinicians should provide such services.

Aim

To Investigate recorded alcohol intake history amongst patients. Assess if relevant guidelines are followed in providing advice or referrals in primary vs secondary care. Based on PHE guidance the standard of this audit is 100% of patients should have their alcohol risk status recorded and managed.

Methods

Clinicians in practice and secondary care were compared with prospective data analysis between May-June, August-September and November-December 2017. Data was collected from 303, medical records based on a proforma including alcohol intake, patient awareness of limits, discussion of health risks, advice on reduction if referral was offered and outcome.

Results

There was an improvement in all aspects of monitored screening and intervention in both settings. In primary care, the guidance of limits and health risks in primary care increased from 20% to 80% and 85% respectively. In secondary care, it increased from 0% to 85%. The recording of intake improved from 90% to 100% in secondary care and maintained at 100% in primary care.

Conclusion

The recording of alcohol intake and subsequent action in both settings was sub-optimal. Therefore, knowledge and support may be withheld from patients, neglecting an opportunity to intervene and reduce alcohol misuse. A standardised way of screening and acting on alcohol was implemented. Results from the second cycle showed improvement in all aspects. Results were displayed in both settings, procedures altered and further training implemented. This is being re-audited November-December 2017 to ensure the recommendations have been implemented and results displayed.

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