Standardised alcohol screening in primary health care services targeting Aboriginal and Torres Strait Islander peoples in Australia
journal contributionposted on 16.06.2021, 02:07 by Md IslamMd Islam, Helen OniHelen Oni, Kylie LeeKylie Lee, Noel Hayman, Scott Wilson, Kristie Harrison, Beth Hummerston, Rowena Ivers, Katherine M Conigrave
Introduction and aims: Aboriginal and Torres Strait Islander Community Controlled Health Services (ACCHSs) around Australia have been asked to standardise screening for unhealthy drinking. Accordingly, screening with the 3-item AUDIT-C (Alcohol Use Disorders Identification Test - Consumption) tool has become a national key performance indicator. Here we provide an overview of suitability of AUDIT-C and other brief alcohol screening tools for use in ACCHSs. Methods: All peer-reviewed literature providing original data on validity, acceptability or feasibility of alcohol screening tools among Indigenous Australians was reviewed. Narrative synthesis was used to identify themes and integrate results. Results: Three screening tools - full AUDIT, AUDIT-3 (third question of AUDIT) and CAGE (Cut-down, Annoyed, Guilty and Eye-opener) have been validated against other consumption measures, and found to correspond well. Short forms of AUDIT have also been found to compare well with full AUDIT, and were preferred by primary care staff. Help was often required with converting consumption into standard drinks. Researchers commented that AUDIT and its short forms prompted reflection on drinking. Another tool, the Indigenous Risk Impact Screen (IRIS), jointly screens for alcohol, drug and mental health risk, but is relatively long (13 items). IRIS has been validated against dependence scales. AUDIT, IRIS and CAGE have a greater focus on dependence than on hazardous or harmful consumption. Discussion and conclusions: Detection of unhealthy drinking before harms occur is a goal of screening, so AUDIT-C offers advantages over tools like IRIS or CAGE which focus on dependence. AUDIT-C's brevity suits integration with general health screening. Further research is needed on facilitating implementation of systematic alcohol screening into Indigenous primary healthcare.
This study was supported by funding contributions from the Australian Institute of Health and Welfare and by the National Health and Medical Research Council (Grants Number ID #1105339, #1087192 and #1117198). The senior author was supported by an NHMRC Practitioner Fellowship (#1117582). We acknowledge the support of Mira Branezac, Library Manager of NSW Health's Drug and Alcohol Health Services Library.
JournalAddiction Science & Clinical Practice
Pagination11p. (p. 1-11)
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Science & TechnologyLife Sciences & BiomedicineSubstance AbuseAlcohol screeningAUDITAUDIT-CIndigenousIRISAboriginal and/or Torres Strait IslanderDISORDERS IDENTIFICATION TESTRANDOMIZED CONTROLLED-TRIALBRIEF INTERVENTIONUNIVERSITY-STUDENTSMEDICAL-SERVICEMENTAL-HEALTHAT-RISKDRUGCONSUMPTIONHumansAlcoholismMass ScreeningReproducibility of ResultsOceanic Ancestry GroupPrimary Health CareAustraliaSurveys and Questionnaires