Health Professionals Screening Tool for Alcohol Use

1
Health Professionals Screening Tool for Alcohol
Use

• Caulette McBride, PHN
• Susan Stewart, Research Associate
• Building Blocks for Change
• Feb. 6-8, 2006

2
Why Develop a Tool?

• Had promoted LRDG to community and workplaces
• Needed to do more to promote the LRDG
• Wanted health professionals support for LRDG

3
Physicians in KFLA

• Majority did not have an understanding of the
  LRDG
• Physicians own philosophy may take precedent

4
Why Target Doctors?

• Patients expect, are willing to discuss alcohol
  use with Dr.
• Canadian Task Force on Periodic Health
  Examination supports intervention
• Brief counseling intervention by physicians is
  effective

5
Features of the Tool

• Reinforces the LRDG
• Describes what a standard drink is
• Lists local resources
• Ask CAGE 2 Y
• Assess
• Advise
• Assist

6
CAGE 2 Y

• C ut down
• A annoyed
• G uilty
• E ye-opener
• Q drinks per day
• Q days per week
• Y occurred in past year? if yes to CAGE

7
Why the CAGE?

• Well-established
• Familiar to doctors
• Still used locally
• Stronger when added 2 questions Y
• Survey support

8
Pilot Study

• Objectives
• To estimate the proportion of physicians and
  other health professionals who used the CAGE2Y
  Screening Tool after it was provided to them
• To gather comments, criticisms and suggestions
  for improvement of the tool.

9
Methodology

• An information package and the CAGE2Y Screening
  Tool were mailed out to the sample of physicians
  and health professionals in the KFLA area.
• The follow-up questionnaire was sent out one
  month later to assess response to the tool.

10
Sample

• 100 physicians from KFLA area were randomly
  selected plus health professionals at Queens
  University, and CFB Health Services Centre and
  Family Medical Clinic were invited to participate
  in the study.
• Response rate was low 20.

11
Prior to Receiving the CAGE2Y

• 100 of health professionals discussed alcohol
  use with their patients, however, only 50
  reported discussing alcohol use with all of their
  patients.
• Alcohol use was discussed more frequently with
  higher risk groups.

12
After Receiving the CAGE2Y

• Little change in clinical practice.
• Only one health professional indicated that
  he/she started screening individuals who drank
  above the LRDG, whether or not the patient was at
  risk of alcohol abuse, since receiving the
  screening tool.

13
Use of the CAGE2Y

• 54 of respondents indicated that they actually
  used the tool to screen patients for alcohol use.
• Potential future usage seems as though it would
  be high, with 69 of respondents indicating that
  they would use the tool in the future.

14
Usefulness of the Tool

• 86 of health care professionals found the tool
  very or somewhat useful.
• 94 found the additional information (LRDG,
  standard-size drink, role of health
  professionals) very or somewhat useful.

15
Suggested Improvements

• Have cards or bookmark information strips that
  could be given to patients.
• Have stickers with questions that could be put
  into patient charts.
• Put screening questions into a general functional
  inquiry form that new and pregnant patients could
  complete.

16
After the Pilot

• Made some of the changes
• Sent to all KFLA physicians
• At same time promoted LRDG and tool through bus
  ads, media release ? TV and radio interviews, PH
  e-bulletin board ad, newsletter articles,
  Workplace mailout
• Inquiring at Queens and St. Lawrence re
  curriculum
• Continue to promote tool to physicians listed as
  a resource in our P.H. binder, CME events etc.
• Happy to share