Improving detection of alcohol misuse in patients presenting to an accident and emergency department

Objectives—To assess and improve deployment of a brief test for alcohol misuse: the Paddington Alcohol Test (PAT). Design—Prospective study of the effects of audit feedback. Setting—An urban accident and emergency department. Subjects—Senior house officers (SHO) (n = 13). Outcome measurements—PAT us...

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Bibliographic Details
Published in:Emergency medicine journal : EMJ 2001-03, Vol.18 (2), p.99-104
Main Authors: Huntley, J S, Blain, C, Hood, S, Touquet, R
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Alcohol
alcohol health worker
alcohol misuse
Alcoholic Intoxication - diagnosis
Alcoholic Intoxication - epidemiology
Alcoholic Intoxication - rehabilitation
Alcoholism
Alcoholism - diagnosis
Alcoholism - rehabilitation
Apathy
Assaults
Audits
Counseling
Cross-Sectional Studies
Diagnosis
Emergency medical care
Emergency medicine
Emergency Service, Hospital
England - epidemiology
Female
Head injuries
Health Status Indicators
Humans
Incidence
Intervention
Male
Middle Aged
Mortality
Original
Paddington Alcohol Test
Personality Assessment - statistics & numerical data
Physicians
Practice
Studies
Trauma
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Summary:Objectives—To assess and improve deployment of a brief test for alcohol misuse: the Paddington Alcohol Test (PAT). Design—Prospective study of the effects of audit feedback. Setting—An urban accident and emergency department. Subjects—Senior house officers (SHO) (n = 13). Outcome measurements—PAT use and categorisation of patients for each SHO; observational analysis of presenting complaints according to PAT. Results—1062 of 1737 patients (61.1%) were defined as PAT possible—that is, presented with ≥ one complaint listed on the PAT test proforma. In month 1, PAT uptake was poor. PAT use improved significantly when feedback was instituted (p collapse (including “fit”, “blackout”) > head injury (including “facial injury”) > assault (including “domestic violence” and `other') > non-specific gastrointestinal problem > “unwell” > psychiatric (including “depression”, “overdose”, “confusion”) > cardiac (including “chest pain” and “palpitations”) > self neglect > repeat attendance. Conclusions—Ongoing audit with feedback improves both PAT use and detection of alcohol misuse. The PAT is now simpler including only 10 conditions, which should further aid its use.
ISSN:1472-0205
1472-0213
DOI:10.1136/emj.18.2.99