PROBLEMS ENCOUNTERED WITH OPPORTUNISTIC SCREENING FOR ALCOHOL-RELATEDPROBLEMS IN PATIENTS ATTENDING AN ACCIDENT AND EMERGENCY DEPARTMENT

Aims. To assess the value of opportunistic screening in Accident and E mergency (A&E) for patients with alcohol-related problems and provisio n of an intervention. Design. Screening of A&E attendees for the purpo se of recruitment to a randomized trial of a counselling intervention. Setting. A General Hospital A&E department. Participants. All 17000 a dult A&E attendees, during a 6-month period and all nursing staff work ing within the department, Measurements. Patients' self-reported alcoh ol consumption responses to the CAGE questionnaire (four questions des igned to identify problem drinking) and proportions offered and taking up offer of help. Findings. Only 4663 (28%) adult attendees at A&E we re actually screened and of these 2% declined and 25% were judged unab le to answer. Of the rest, 86% drank alcohol, with 22% drinking in exc ess of current guidelines or with two or more positive answers to CAGE . Only 41% (264) of those drinking to excess were offered help and 88% of these declined it. This left 13 patients to be included in the tri al. Conclusion. There is a significant need for an effective intervent ion in the area but considerable barriers exist to testing the efficac y of potential screening strategies and interventions.