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Gegevens

Gepubliceerd op woensdag 07 december 2011 09:56

Identifying problematic consumption (= hazardous and harmful drinking) of alcohol

1. Conduct the AUDIT (Alcohol Use Disorder Identification Test) when there are signs of problematic alcohol consumption and on the occasion of a general health examination (GRADE 2C).

2. Proceed step-by-step in the identification (GRADE 2C).

• Step 1: Ask questions 1 through 3 of the AUDIT.
• Step 2: Then ask questions 4 through 10 of the AUDIT (GRADE 1B) for men < 65 years old if the score for the first three questions equals five or more and for women and everyone over 65 if the score equals four or more.

3. Biochemical/ biological tests are not indicated to identify problematic alcohol consumption (GRADE 2C).

4. Encourage the patient not to change his or her "acceptable" alcohol consumption with a score from 0 through 7 for men younger than 65 years old and 0 through 6 for women and everybody over 65.

5. Offer brief advice (see further) with an AUDIT score from 8 through 19 for men < 65 years old and from 7 through 19 for women and everybody over 65.

6. Refer for specialist treatment with an AUDIT score that exceeds 19.

Therapeutic approach (interventions ) of (treating problematic alcohol consumption) with problematic alcohol consumption

The brief advice

7. Give (deliver) brief advice (GRADE 1A).

• discuss the AUDIT score.
• Indicate (itemized , emphasized) the personal risks of problematic alcohol consumption and introduce the need for change;
• point out what may be the acceptable amounts of alcohol;
• give a folder to reinforce this brief advice (all GRADE 2C)

Follow-up and short intervention (= extended brief intervention) (GRADE 2C)

8. Repeat the brief advice when there are new signals in the situation of the AUDIT score ≤ 15.

9. Schedule a follow-up discussion if the AUDIT score is 16 through 19. Repeat in this follow-up discussion the brief advice or consider using the ABC model for counseling about alcohol abuse (developed by the Flemisch Domus Medica) when the alcohol consumption remained undiminished (unreduced? Of unchanged ).

Referral ( GRADE 2C)

10. Refer patients for specialized treatment for alcohol problems (to specialized assistance) with an AUDIT score ≥ 20 (when they score 20 or more on the AUDIT of 'that exceeds 19' of 'that equals 20 or more') , with psychiatric co-morbidity and also if the problematic alcohol consumption remains the same after repeated but brief advice.