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APHA Scientific Session and Event Listing

Jennifer C. Smith, EdM¹, Michael J. Mello, MD, MPH¹, Aemi Tiemo, BS², Julia Harris³, Magdalena A. Harrington, MS¹, Ted D. Nirenberg, PhD¹, Janette Baird, PhD⁴, and Robert Woolard, MD⁵. (1) Injury Prevention Center, Rhode Island Hospital, 110 Lockwood Street, Suite 334, Providence, RI 02903, 401-255-3247, jsmith3@lifespan.org, (2) Injury Prevention Center, Rhode Island Hopsital, 110 Lockwood Street, Suite 334, Providence, RI 02903, (3) Brown University Medical School, Box G-A, Providence, RI 02912, (4) Injury Prevention Center, 110 Lockwood Street, Room 334, Providence, RI 02903, (5) Emergency Medicine, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02874

OBJECTIVE: Previous research demonstrates that 24-31% of ED patients screen positive for alcohol-related problems, utilizing the CAGE questionnaire. Therefore, an ED visit is an ideal opportunity to provide early detection and intervention. We examine the prevalence of alcohol screening and referral to treatment resources in two Rhode Island community hospital EDs. METHOD: A retrospective review of ED charts was conducted to determine rates of alcohol screening and treatment or referral to treatment. 508 charts were reviewed (254 per ED) during a one-month period according to an explicit sampling protocol. This was preliminary to a larger study examining the integration of alcohol screening and brief intervention into a community ED. RESULTS: Of 508 records reviewed, 67% had some type of documented screening for alcohol use, 31% of those screened were positive for any use, and 3% of the patients were acutely intoxicated. While screening methods utilized varied, 98% of documented screening used neither recognized screening rubric nor quantitative measures. Alcohol treatment or referral was offered to 75% (12/16) of acutely intoxicated patients (or 4% of all screened patients) but less than 1% of the other screened patients (4/342). CONCLUSIONS: These data demonstrate that an opportunity for early detection and intervention of alcohol problems is being missed in both screening and treatment/referral in community EDs. Unless the patient presents acutely intoxicated, treatment/referral occurs too infrequently, and methods of screening are insufficient to capture anticipated numbers of problem drinkers.

Learning Objectives: At the conclusion of the session, the participant (learner) will be able to

• Describe patients screened for alcohol use in community EDs.
• Describe alcohol-screening methods used in community EDs.
• Understand the adequacy of alcohol screening and treatment/referralin community EDs.

Keywords: Alcohol, Screening

Presenting author's disclosure statement:

Any relevant financial relationships? No