Before
You Begin…
Decide
on a screening method
The Guide provides two methods for
screening: a single question (about heavy drinking days) to use during a clinical
interview and a written self-report instrument (the
AUDIT—see page 11). The single interview question can be used at any
time, either in conjunction with the AUDIT or alone. Some practices may prefer
to have patients fill out the AUDIT before they see the clinician. It takes less
than 5 minutes to complete and can be copied or incorporated into a health history.
Think
about clinical indications for screening
Key
opportunities include
-
As part of a routine examination
-
Before prescribing a medication that interacts with alcohol (see
box on page 29)
- In
the emergency department or urgent care center
- When
seeing patients who
- are pregnant or trying
to conceive
- are likely to drink heavily, such as smokers,
adolescents, and young adults
- have health problems that might
be alcohol induced, such as:
- cardiac arrhythmia
- dyspepsia
- liver disease
- depression or anxiety
- insomnia
- trauma
- have
a chronic illness that isn't responding to treatment as expected, such
as:
- chronic pain
- diabetes
- gastrointestinal disorders
- depression
- heart disease
- hypertension
Set
up your practice to simplify the process
-
Decide who will conduct the screening (you, other clinical personnel, the receptionist
who hands out the AUDIT)
- Use preformatted progress notes (see "Online Materials" on page 27)
- Use
computer reminders (if using electronic medical records)
- Keep copies of
the pocket guide (provided) and referral information in your examination rooms
- Monitor
your performance through practice audits
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