Commenced in January 2007
Paper Count: 31106
CAGE Questionnaire as a Screening Tool for Hazardous Drinking in an Acute Admissions Ward: Frequency of Application and Comparison with AUDIT-C Questionnaire
Abstract:The aim of this audit was to examine the efficiency of alcohol history documentation and screening for hazardous drinkers at the Medical Admission Unit (MAU) of Northern General Hospital (NGH), Sheffield, to identify any potential for enhancing clinical practice. Data were collected from medical clerking sheets, ICE system and directly from 82 patients by three junior medical doctors using both CAGE questionnaire and AUDIT-C tool for newly admitted patients to MAU in NGH, in the period between January and March 2015. Alcohol consumption was documented in around two-third of the patient sample and this was documented fairly accurately by health care professionals. Some used subjective words such as 'social drinking' in the alcohol units’ section of the history. CAGE questionnaire was applied to only four patients and none of the patients had documented advice, education or referral to an alcohol liaison team. AUDIT-C tool had identified 30.4%, while CAGE 10.9%, of patients admitted to the NGH MAU as hazardous drinkers. The amount of alcohol the patient consumes positively correlated with the score of AUDIT-C (Pearson correlation 0.83). Re-audit is planned to be carried out after integrating AUDIT-C tool as labels in the notes and presenting a brief teaching session to junior doctors. Alcohol misuse screening is not adequately undertaken and no appropriate action is being offered to hazardous drinkers. CAGE questionnaire is poorly applied to patients and when satisfactory and adequately used has low sensitivity to detect hazardous drinkers in comparison with AUDIT-C tool. Re-audit of alcohol screening practice after introducing AUDIT-C tool in clerking sheets (as labels) is required to compare the findings and conclude the audit cycle.
Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1111929Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 1533
 Alcohol treatment in England. The Department of Health (DOH). Report 2012.
 Janiper M, Smith N, Kelly K, Mason M. Measuring the units: a review of patients who died with alcohol-related liver disease. National Confidential Enquiry into Patient Outcome and Death. NCEPOD, 2013.
 Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence. NICE Guidelines.2011.
 Shevlin M, Smith BW. The factor structure and concurrent validity of the Alcohol Use Disorder Identification Test based on a nationally representative UK sample. Alcohol & Alcoholism. 2007; 42, 582–587.
 Meneses-Gaya C, Zuardi A, Loureiro S, Crippa J. Alcohol Use Disorders Identification Test (AUDIT): An updated systematic review of psychometric properties. Psychology and Neuroscience. 2009; 2(1):83–97.
 Dawson, D.A., Grant, B.F., Stinson, F.S., Zhou, Y. Effectiveness of the derived Alcohol Use Disorders Identification Test (AUDIT-C) in screening for alcohol use disorders and risk drinking in the US general population. Alcoholism: Clinical and Experimental research.2007; 29, 844-854.
 Bradley KA, DeBenedetti AF, Volk RJ. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res 2007;31:1208-17.
 Kriston L, Ho L. Meta-analysis: Are 3 Questions Enough to Detect Unhealthy Alcohol use? Review Annals of Internal Medicine 2009; 149(12):879-88.
 West Sussex NHS Trust. Alcohol misuse identification: a guide for professionals. Available from: http://www.westsussex.nhs.uk/alcoholprofessionals (Accessed Dec 2014).
 Blackpool Teaching Hospitals NHS Foundation Trust. Case Study: Alcohol ‘Identification and Brief Advice’ (IBA) Training. Available from: https://www.ewin.nhs.uk/resources/item/3250/alcohol-identification-and-brief-advice-iba-training (Accessed Dec 2014)
 The NHS Health Check Programme. Best practice guidance. Available from: www.healthcheck.nhs.uk/document.php?o=456 (Accessed Dec 2014)