DETECTION OF ALCOHOL MISUSING PATIENTS IN ACCIDENT AND EMERGENCY DEPARTMENTS - THE PADDINGTON ALCOHOL TEST (PAT)

Objective-To develop an effective but practical screening questionnair e for use by accident and emergency (A&E) staff to detect alcohol misu se early on in its natural history, without unreasonably prolonging pa tient waiting times; and to integrate an alcohol health worker (AHW) i nto A&E to provide counselling for referred patients. Methods-Two pilo t studies for adult patients were undertaken to develop the 1 min Padd ington alcohol test (PAT), which has only three compulsory questions f or detecting alcohol misuse: two cover peak consumption and frequency of possible binge drinking, and the third asks whether in the patients ' view their attendance at A&E was alcohol related, The use of the PAT was validated in ''appropriate'' adult patients over a one year perio d, Patients found to be positive were invited to attend the A&E review clinic for counselling by the AHW. Results-The development of the PAT resulted in a referral rate of one patient per 158 A&E adult attender s, facilitating a counselling rate of one patient per 263 A&E adult at tenders by the AHW. This counselling rate is a 10-fold increase on the rate of one patient per 2610 adult attenders found in a study underta ken during 1988-90. Conclusions-The use of the PAT is one practical me thod for A&E staff to detect the alcohol misusing patient for referral to a departmental alcohol health worker.