Title: Identification and Brief Advice Tools and Techniques
1Identification and Brief AdviceTools and
Techniques
2Alcohol 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.
3Support 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
4Part 1Opportunistic Case Identification orScre
ening
5Point 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)
6Questions
- 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
7AUDIT Gold Standard
8Primary 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
9AUDIT - C
10AUDIT - PC
11FAST Fast Alcohol Screening Test
12SASQ Single Alcohol Screening Questionnaire
13Primary 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
14AUDIT Gold Standard
15Primary 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
16Part 2Brief Advice orBrief Intervention
17Brief Advice
- Understanding units
- Understanding risk levels
- Knowing where they sit on the risk scale
- Benefits of cutting down
- Tips for cutting down
18Understanding Units
19(No Transcript)
20Risk Levels
21Where do they sit?
Male Female
Abstainers Lower Increased Higher
Risk Risk Risk
22Benefits 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
23Tips 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
24Part 3Brief Lifestyle Counselling orExtended
Brief Intervention
25Interactive 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?
26Six-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.
27Useful 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/