Alcoholics are often going undiagnosed

By Piriya Mahendra, MedWire Reporter

Medical staff often do not spot alcohol problems in their patients unless they are already intoxicated, say UK researchers from the University of Leicester.

Alex Mitchell and team's study showed that general practitioners (GPs) recorded alcohol problems in only 27.3% of the medical records of 10,997 people with problem drinking, but actually recognized alcohol use disorder in 41.7% using clinical judgment.

The authors note that according to these findings, GPs typically identify eight cases of alcohol abuse but miss 12.

Hospital staff correctly recorded alcohol problems in 37.2% of 10,837 people's cases notes. Based on clinical judgment, at interview, they correctly identified 52.4%. The authors calculated that hospital staff typically identify 10 cases and miss 10.

Mental health professionals correctly identified alcohol use disorder in 54.7% of 384 cases with alcohol use disorder. Based on clinical judgment, their detection specificity was 83.6%. Mental health professionals would typically identify 11 cases and miss nine, the authors say.

Additional analysis of four studies that examined the ability of doctors and nurses working in trauma centers to identify acute alcohol intoxication, defined by high blood alcohol concentration, showed that they identified intoxication in 89.8% of cases based on clinical judgment.

"This study highlights that clinical identification of alcohol problems is challenging in busy clinical environments. When clinicians try and spot alcohol problems they often miss patients who have serious alcohol problems but who are not currently intoxicated," commented Mitchell in a press statement.

He explained that clinicians are sometimes unsure of what questions to ask or which screening tests to apply. He added that it was not the case that patients refused to admit alcohol problems. "In fact it was more common for patients to disclose problem drinking when asked to self-report than the number found by clinicians' judgment alone," he remarked.

"There needs to be a greater awareness of the importance of carefully assessing alcohol problems for nonintoxicated patients. Patient responses to questioning about drinking habits should not be assumed to be misleading but questioning must be handled sensitively."

Licensed from medwireNews with permission from Springer Healthcare Ltd. ©Springer Healthcare Ltd. All rights reserved. Neither of these parties endorse or recommend any commercial products, services, or equipment.