Would you take up alcohol screening?


Pharmacists may be able to help reduce alcohol-related problems in the community through screening and interventions

Alcohol is consumed widely in Australia and harmful levels of consumption are a major health issue, associated with increased risk of chronic disease, injury and premature death.

Latest data shows that among Australians aged 12 and older, more than one in three (37%) had consumed five or more standard drinks on a single occasion at least once in the past year, therefore exceeding the NHMRC single occasion risk guidelines.

Requesting non-prescription medicines to deal with symptoms associated with inappropriate alcohol use, such as indigestion, headaches and hangover, is one reason why people may present to a pharmacy.

This level of access to people with potentially risky drinking behaviours is what spurred health researchers from Curtin University in WA to conduct a feasibility study into screening for alcohol-related problems in community pharmacies.

They recruited five Australian pharmacies and trained staff to deliver screening and brief interventions.

Fifty consumer participants were screened – 10 from each pharmacy, with most (67%) aged 25 to 55.

Responses to the screening and intervention process were “generally favourable”: for example, 75% agreed that it was either appropriate or very appropriate to be asked about their alcohol consumption.

Of 11 participants who were contactable three months later, three of the five non-low risk drinkers had reduced their level of risk over the three months.

Ten pharmacists who were interviewed about their experience were generally positive about the intervention, citing reasons such as flexibility, ease of use, perceived positive impact, and an enhanced role of community pharmacists.

While alcohol screening is not yet something that has taken off in Australia, pharmacy managers tell AJP they would be interested in implementing such a service.

Western Australia’s award-winning Pharmacy 777, for example, says it doesn’t currently screen for alcohol-related issues except through its lauded mental health program.

“We have a mental health counsellor on site that offers alcohol counselling support,” explains Pharmacy 777 General Manager Jovana Seat.

However she sees the need for alcohol screening to go beyond mental health support.

“Alcohol abuse adversely impacts health, including increased risk and complications of chronic health issues, not just mental health,” she says.

“Anything that can increase patient’s compliance to recommended therapy/lifestyle as well as improve their health outcome would be a very useful tool. This can be used by community pharmacists in collaboration with the patient’s general practitioner to monitor patients’ therapy and make further recommendations as necessary,” says Seat.

Stuart Nankivell, pharmacist manager at Terry White Chemists in Chatswood Chase, says he would be interested in finding out more about the potential for screening of alcohol-related problems.

“We don’t currently screen for alcohol-related issues. I’d need to find out more information on it and obviously we’d need to make sure our staff were properly trained and upskilled for that purpose,” says Nankivell.

“The most common alcohol-related issue we come across is frequency of drinking, so drinking outside the recommended guidelines. That’s our biggest concern. And also we come across alcohol dependency issues.”

According to the National Drug Strategy Household Survey 2013 report, long-term harmful drinking may result in alcohol dependence and other chronic conditions such as high blood pressure, cardiovascular diseases, cirrhosis of the liver, types of dementia, mental health problems and various cancers.

Sources:

National Drug Strategy Household Survey detailed report: 2013, Australian Institute of Health and Welfare.

‘Making the invisible visible’ through alcohol screening and brief intervention in community pharmacies: an Australian feasibility studyBMC Public Health.

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