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Alcohol Aware Practice

EU Study – Barcelona, 23-25 February, 2003. Alcohol Aware Practice. A Joint ICGP/Department of Health Initiative. Rolande Anderson , Project Director, “Helping Patients with Alcohol Problems”, Irish College of General Practitioners, 4-5 Lincoln Place, Dublin 2

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Alcohol Aware Practice

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  1. EU Study – Barcelona, 23-25 February, 2003 Alcohol Aware Practice A Joint ICGP/Department of Health Initiative Rolande Anderson, Project Director, “Helping Patients with Alcohol Problems”, Irish College of General Practitioners, 4-5 Lincoln Place, Dublin 2 Supported by Merck Pharmaceuticals.

  2. 12.3 litres of pure alcohol per capita (2000) 2nd Beer consumption in world. Alcoholic drinks market worth €6.81 billion Approx. ¼ drinking above “safe” limits. Irish people 47% + on alcoholic drinks 2000 v 1996 Why? ? ‘Celtic Tiger’ ? Availability ? Marketting Mater Hospital study In-patients Alcohol Abuse or Dependence 30% Male 8% Female ESPAD Study Ireland top of the league for binge drinking among females Statistics

  3. Aims To develop, at a General Practice level, programmes of concerted action involving all practice staff, in order to prevent, detect and treat patient problems associated with alcohol. Alcohol Aware Practice Pilot Study

  4. Urine Tests Blood Tests Breathalyser Clinical Examination Asking Questionnaires CAGE Brief Mast AUDIT AUDIT C Five Shot Screening Methods

  5. Increasing staff awareness and expertise. Improving individual patient records of alcohol consumption. Developing an education / information plan. Training doctors to intervene effectively during every consultation. Training Practice Nurses. Maintaining intervention records. We do this by……

  6. Establishing practice policy on referral for more intensive care. Developing practice advocacy for such services where they are currently inadequate Appropriate use of screening instruments. Categorising all patients as ‘Non-Drinkers’, ‘Low risk’, ‘Hazardous’, ‘Harmful’ and ‘Dependent’ drinkers. Developing management guidelines appropriate to each category. We do this by……

  7. Questionnaire A.U.D.I.T. 1:5 patients 1:9 CAGE RANDOM Blood Tests LFT’s MCV Allocation of Patients Low risk Hazardous drinking Harmful Dependent Brief Intervention Exclusion criteria Training – key practice staff Follow-up Referral Materials Methods

  8. Health Board Areas of Ireland

  9. The Area Covered by the ERHA

  10. AAP Pilot Study Participating Practices

  11. Results • The results will look at the training programme and the three main areas of the study – screening, detection, treatment and referral. • Weekly consumption of standard drinks will be recorded at the initial interview and again at a 3 month follow-up interview. • Numbers screened and the percentage of those screened who fit into the ‘diagnostic categories’ ie. low risk, hazardous etc • Figures will be broken down for each region with age and sex profiles. • Action taken in terms of treatment and referral will also form part of the results. • The practice staff will also be asked to evaluate the training programme, materials and pilot study.

  12. AAP Recording Form

  13. Evaluation • Comfort levels before and after on SCALES of 0-10: • Dealing with alcohol problems • Knowledge of withdrawal • Awareness of referral services • Knowledge of “safe”/weekly consumption levels • Ability to use questionnaires • Knowledge of brief intervention • Confidence in Dealing with Alcohol Problems • Other Comments

  14. Most Significant Advances • ICGP Project “Helping Patients with Alcohol Problems” March 2000-February 2003. • National Conference – “Alcohol and Young People”, October 2001. • Alcohol Aware Practice Pilot Study (six months) commenced 4 September 2002

  15. Barriers • Funding • GP Attitudes • GP Confidence

  16. Key Advances 2003-2004 • Expanded AAP Study • Central Government Funding • Training for GPs and Practice Nurses • More committed personnel • Special Type Consultation Fees

  17. To make changes possible • Belief that it is worthwhile amongst GPs • Shifts in attitudes • GPs • Governmental • Health Boards • Funding increases

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