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How Can Risk Drinking Amongst Medical Patients be Modified? The Effects of Computer Screening and Advice and a Self-Help Manual

Published online by Cambridge University Press:  16 June 2009

Victoria Daniels ,
Marcia Somers ,
Jim Orford  and
Brian Kirby
Victoria Daniels
Affiliation:
University of Exeter
Marcia Somers
Affiliation:
University of Exeter
Jim Orford
Affiliation:
University of Exeter
Brian Kirby
Affiliation:
Postgraduate Medical School, Exeter
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Extract

547 patients admitted to the medical wards of a general hospital in South West England completed a computer-administered health behaviour screening questionnaire. This included a retrospective week's drinking diary and questions about alcohol-related problems. All patients were shown, via the computer, a summary of their own week's drinking in comparison with nationally recommended upper limits for safe drinking. In addition, all those who were considered to be risk drinkers on the basis of consumption or problems (23% of males, 7% of females) were advised via the computer to reduce their consumption and were given an approved self-help manual. All risk drinkers and a proportion of others were asked to complete the same questionnaire six months later. Seventy-five per cent of those asked, did so. The computer screening procedure was well accepted into ward routine and a simple before and after comparison showed a slight but significant reduction in drinking risk for the group as a whole. Regression discontinuity analysis showed that computer advice to reduce consumption plus provision of the self-help manual was of no additional benefit in helping patients reduce drinking risk.

Type
Clinical Section
Information
Behavioural and Cognitive Psychotherapy , Volume 20 , Issue 1 , January 1992 , pp. 47 - 60
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1992

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References

Berk, R. A. and Rauma, D. (1983). Capitalizing on nonrandom assignment to treatment: a regression discontinuity analysis of a crime control program. Journal of the American Statistical Association 78, 21–28.CrossRefGoogle Scholar
Bernadt, M., Taylor, G., Mumford, J., Smith, B. and Murray, M. (1982). Comparison of questionnaire and laboratory tests in the detection of excessive drinking and alcoholism. Lancet i, 325–328.CrossRefGoogle Scholar
Bush, B., Shaw, S., Cleary, P., Delbanco, T. L. and Aronson, M. D. (1987). Screening for alcohol abuse using the CAGE questionnaire. American Journal of Medicine 82, 231–235.CrossRefGoogle ScholarPubMed
Caviston, P. (1988). Alcohol services: exhortations rather than commitment. British Medical Journal 297, 241.CrossRefGoogle ScholarPubMed
Chick, J., Lloyd, G. and Crombie, E. (1985). Counselling problem drinkers in medical wards: a controlled study. British Medical Journal 290, 265–267.Google ScholarPubMed
Cook, T. D. and Campbell, D. T. (1979). Quasi-experimentation: Design and Analysis Issues for Field Settings. Chicago: Rand McNally.Google Scholar
Duffy, J. C. and Waterton, J. J. (1984). Under-reporting of alcohol consumption in sample surveys: the effect of computer interviewing in fieldwork. British Journal of Addiction 79, 305–308.CrossRefGoogle ScholarPubMed
Edwards, G., Duckitt, A., Oppenheimer, E., Shehan, M. and Taylor, C. (1983). What happens to alcoholics? Lancet ii, 269–271.CrossRefGoogle Scholar
Edwards, G., Orford, J., Egert, S., Guthrie, S., Hawker, A., Hensman, C., Mitcheson, M., Oppenheimer, E. and Taylor, C. (1977). Alcoholism: a controlled trial of “treatment” and “advice”. Journal of Studies on Alcohol 38, 1004–1031.CrossRefGoogle ScholarPubMed
Elvy, G. A., Wells, J. E. and Baird, K. A. (1988). Attempted referral as intervention for problem drinking in the general hospital. British Journal of Addiction 83, 83–89.CrossRefGoogle ScholarPubMed
Heather, N. (1986). Minimal treatment interventions for problem drinkers. In Edwards, G. and Gill, D. (Eds). Current Issues in Clinical Psychology. (pp. 120–156) Vol. 4. London: Plenum.Google Scholar
Heynes, T. (1986). Detecting the rate of hidden alcoholism in acute admissions in a general hospital in the South West. Unpublished dissertation, Department of Psychology, University of Exeter, UK.Google Scholar
Kristenson, H., Ohlin, H., Hulten-Nosslin, M. B., Trell, E. and Hood, B. (1982). Identification and intervention of heavy drinking in middle-aged men: results and follow-up of 24–60 month of long-term study with randomized controls. Alcholism: Clinical and Experimental Research 7, 203–209.CrossRefGoogle Scholar
Kristenson, H. and Trell, E. (1982). Indicators of alcohol consumption. Comparisons between a questionnaire (Mm-MAST), interviews and serum-gamma-glutamyl-transferase (GGT) in a health survey of middle-aged males. British Journal of Addiction 77, 297–304.CrossRefGoogle Scholar
Lloyd, G., Chick, J. and Crombie, E. (1982). Screening for problem drinkers among medical in-patients. Drug and Alcohol Dependence 10, 355–359.CrossRefGoogle Scholar
Lockhart, S. P., Carter, Y. H., Straffen, A. M., Pang, K. K., McLoughlin, J. and Baron, J. H. (1986). Detecting alcohol consumption as a cause of emergency general medical admissions. Journal of the Royal Society of Medicine 79, 132–136.CrossRefGoogle ScholarPubMed
Mayfield, D., McLeod, G. and Hall, P. (1974). The CAGE Questionnaire: validation of a new alcoholism screening instrument. American Journal of Psychiatry 131, 1121–1123.CrossRefGoogle ScholarPubMed
Miller, W. R. and Taylor, C. A. (1980). Relative effectiveness of bibliotherapy, individual and group self-control training in the treatment of problem drinkers. Addictive Behaviours 5, 13–24.CrossRefGoogle ScholarPubMed
Moore, P. A. (1972). The diagnosis of alcoholism in a psychiatric hospital: a trial of the MAST. American Journal of Psychiatry 128, 15–65.CrossRefGoogle Scholar
Orford, J. (1990). Alchohol problems in the community. In Bennett, D. and Freeman, H. (Eds). Community Psychiatry. London: Churchill Livingstone.Google Scholar
Orford, J., Somers, M., Daniels, V. and Kirby, B. (1991). Are heavy drinking medical patients contemplating change? A test of the stages of change model. Paper in preparation.Google Scholar
Porkony, A. D., Byron, A. M. and Howard, B. K. (1972). The brief MAST: a shortened version of the Michigan Alcohol Screening Test. American Journal of Psychiatry 129, 342–345.Google Scholar
Robertson, I. and Heather, N. (1986). Let's Drink to Your Health! A Self-help Guide to Sensible Drinking. Leicester: The British Psychological Society.Google Scholar
Royal College of General Practitioners (1986). Alcohol: A Balanced View. London: RCGP.Google Scholar
Royal College of Physicians (1987). A Great and Growing Evil: The Medical Consequences of Alcohol Abuse. London: RCP.Google Scholar
Selzer, M. L. (1971). The quest for a new diagnostic instrument. American Journal of Psychiatry 131, 1121–1123.Google Scholar
Skinner, H. A., Allen, B. A., McIntosh, M. C. and Palmer, W. H. (1985). Lifestyle assessment: applying microcomputers in family practice. British Medical Journal 290, 212–214.CrossRefGoogle ScholarPubMed
Trochim, W. M. K. (1984). Research Design for Program Evaluation: The Regression Discontinuity Approach. New York: Sage.Google Scholar
Wallace, P. G. and Haines, A. P. (1984). General practitioner and health promotion: what patients think. British Medical Journal 289, 534–536.CrossRefGoogle Scholar
Wallace, P. G. and Haines, A. P. (1985). Use of a questionnaire in general practice to increase the recognition of patients with excessive alcohol consumption. British Medical Journal 290, 1949–1953.CrossRefGoogle ScholarPubMed
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