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Identification and Brief Advice Tools and Techniques

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26% (around 10 million) of adults in England drink more than the ... Explore other interests such as cinema, exercise, etc. Avoid going to the pub after work ... – PowerPoint PPT presentation

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Title: Identification and Brief Advice Tools and Techniques


1
Identification and Brief AdviceTools and
Techniques
2
Alcohol in England
  • 90 of adults drink alcohol
  • DH lower-risk guidelines
  • Men should not regularly exceed 3-4 units/day
  • Women should not regularly exceed 2-3 units/day
  • 26 (around 10 million) of adults in England
    drink more than the Government's lower-risk
    guidelines
  • Almost 2.6 million adults drink at higher-risk
  • 1.6 million men drink 50 units/week
  • 1 million women drink more 35 units/week.

3
Support to primary care
  • DES New registrations
  • Primary Care Service Framework
  • Background knowledge and implementation details
  • Examples of practice
  • Identification tools
  • Brief advice scripts
  • Care pathway
  • E-Learning module
  • Read codes
  • Templates for GP computer systems

4
Part 1Opportunistic Case Identification orScre
ening
5
Point of Clarification
  • Opportunistic alcohol case Identification and the
    delivery of Brief Advice (IBA)
  • is the same as
  • Screening and Brief Interventions for alcohol
    misuse (SBI)

6
Questions
  • How many Units do you drink a week?
  • Common questionnaires
  • MAST Michigan Alcohol Screening Test
  • CAGE
  • Have you ever tried to Cut down on your drinking?
  • Have you ever felt Angered by someone talking
    about your drinking?
  • Have you ever felt Guilty about your drinking?
  • Have you ever had to have an Eye opener drink
    in the morning?
  • World Health Organisation (WHO) developed AUDIT
  • Alcohol Use Disorder Identification Test AUDIT
  • Measures both consumption and consequences

7
AUDIT Gold Standard
8
Primary Care - Alcohol Care Pathway
Adults 18-64 visiting GP
Other health complaint
New Registration
Requesting help with alcohol problem
SASQ FAST AUDIT C AUDIT -PC
No action
Initial Screen
Neg
Positive
Full Screen AUDIT
AUDIT Score 8-15
AUDIT Score 16-20
AUDIT Score 20
AUDIT Score 0-7
Extended Brief Advice
Brief Advice
Referral to Specialist Services
Full Assessment
9
AUDIT - C
10
AUDIT - PC
11
FAST Fast Alcohol Screening Test
12
SASQ Single Alcohol Screening Questionnaire
13
Primary Care - Alcohol Care Pathway
Adults 18-64 visiting GP
Other health complaint
New Registration
Requesting help with alcohol problem
SASQ FAST AUDIT C AUDIT -PC
No action
Initial Screen
Neg
Positive
Full Screen AUDIT
AUDIT Score 8-15
AUDIT Score 16-20
AUDIT Score 20
AUDIT Score 0-7
Extended Brief Advice
Brief Advice
Referral to Specialist Services
Full Assessment
14
AUDIT Gold Standard
15
Primary Care - Alcohol Care Pathway
Adults 18-64 visiting GP
Other health complaint
New Registration
Requesting help with alcohol problem
SASQ FAST AUDIT C AUDIT -PC
No action
Initial Screen
Neg
Positive
Full Screen AUDIT
AUDIT Score 8-15
AUDIT Score 16-20
AUDIT Score 20
AUDIT Score 0-7
Extended Brief Advice
Brief Advice
Referral to Specialist Services
Full Assessment
16
Part 2Brief Advice orBrief Intervention
17
Brief Advice
  • Understanding units
  • Understanding risk levels
  • Knowing where they sit on the risk scale
  • Benefits of cutting down
  • Tips for cutting down

18
Understanding Units
19
(No Transcript)
20
Risk Levels
21
Where do they sit?
Male Female
Abstainers Lower Increased Higher
Risk Risk Risk
22
Benefits of cutting down
  • Physical
  • Reduced risk of injury
  • Reduced risk of high blood pressure
  • Reduced risk of cancer
  • Reduced risks of liver disease
  • Reduced risks of brain damage
  • Sleep better
  • More energy
  • Lose weight
  • No hangovers
  • Improved memory
  • Better physical shape
  • Psychological/Social/Financial
  • Improved mood
  • Improved relationships
  • Reduced risks of drink driving
  • Save money

23
Tips for cutting down
  • Have an alcohol-free day once or twice a week
  • Plan activities and tasks at those times you
    usually drink
  • When bored or stressed have a workout instead of
    drinking
  • Explore other interests such as cinema, exercise,
    etc.
  • Avoid going to the pub after work
  • Have your first drink after starting to eat
  • Quench your thirst with non-alcohol drinks before
    alcohol
  • Avoid drinking in rounds or in large groups
  • Switch to low alcohol beer/lager
  • Avoid or limit the time spent with heavy
    drinking friends

24
Part 3Brief Lifestyle Counselling orExtended
Brief Intervention
25
Interactive exchange
  • How important is it for you to reduce your
    drinking?
  • If you decided to reduce your drinking, how
    confident are you that you would succeed?
  • What might be the not so good things about
    reducing your drinking?
  • What might be the good things about reducing your
    drinking?

26
Six-step plan
  • Identify good reasons for changing Can you think
    of 2-3 good reasons?
  • Set yourself a goal to achieve change Is this
    achievable?
  • Recognise difficult times or situations When
    might be the hardest times?
  • Prepare for difficult times/ situations Think of
    a way of dealing with hard times?
  • Find Someone to support you Is there a family
    member/ friend who might help?
  • Stick to your goals but remember, nobodys
    perfect! If at first you dont succeed, try
    again.

27
Useful Links
  • Primary Care Framework
  • http//www.primarycarecontracting.nhs.uk/204.php
  • Newcastle University SBI materials
  • http//www.ncl.ac.uk/ihs/news/item/?brief-interve
    ntions-alcohol-and-health-improvement
  • SIPS Research Programme
  • http//www.sips.iop.kcl.ac.uk/index.php
  • Units Calculator and Drink Check (on-line AUDIT)
  • http//www.units.nhs.uk/
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