Implementation of alcohol screening and brief intervention in endoscopy

Gillian O’Neill, Steven Masson, Lesley Bewick, Jill Doyle, Ruth McGovern, Elaine Stoker, Helen Wright, Dorothy Newbury-Birch

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    Screening adults for risky alcohol consumption and provision of brief intervention should be routine practice in
    secondary care
    . The feasibility of implementing this in endoscopy departments has not been studied. The aim of this study was to
    evaluate the feasibility of routine implementation of alcohol screening and brief intervention (ASBI) and understand associated
    healthcare professional behaviour change in a 12-week pilot in a busy endoscopy department in a university teaching hospital.
    Using the
    MRC's framework for developing and evaluating complex interventions, an evaluation was completed.
    Normalisation Process Theory and the Theoretical Domains Framework theory was applied, in conjunction with evidence based tools
    for professional behaviour change. The evaluation included the utilisation of clinical champions, one hour face to face alcohol
    training sessions, tailored education materials bespoke to endoscopy and a twelve week pilot delivering ASBI as part of routine
    During the twelve week pilot, anonymised patient data was collected on Alcohol Use Disorders Identification Tool (AUDIT) score
    and whether patients received a brief intervention. Statistical analysis of the AUDIT questionnaires was performed using SPSS.
    Quantitative questionnaires and qualitative focus groups were used to assess the behaviour change of endoscopy nurses. Staff
    questionnaires were completed at 3 time points (before alcohol training, immediately after alcohol training, after 12 weeks) and
    included the validated Shortened Alcohol and Alcohol Problems Questionnaire (SAAPPQ). Transcripts from the focus groups were
    analysed using a framework analysis approach.
    During the 12-week pilot, most (n=1136, 71%) endoscopy patients completed an AUDIT questionnaire. Of these, 96%
    received personalised feedback on their score and 65% of patients drinking at increasing risk levels or above accepted a brief
    intervention. Quantitative staff questionnaire (including SAAPQ) results and qualitative focus group analysis demonstrated a positive
    shift in nurses’ attitudes towards discussing alcohol with patients. An increase in nurses’ knowledge, skills and confidence to talk to
    patients about alcohol was also demonstrated.
    A multi-method approach to implementation can result in the pragmatic application of theory, leading to successful
    embedding of evidence based practice. It is feasible to embed ASBI into routine practice in endosccopy, thus fulfilling the objective
    of making every contact a health-improving opportunity
    Original languageEnglish
    Publication statusPublished - 2014
    EventBritish Society of Gerontology Annual Conference 2014 - University of Southampton, Southampton, United Kingdom
    Duration: 1 Sept 20143 Sept 2014


    ConferenceBritish Society of Gerontology Annual Conference 2014
    Abbreviated titleBSG2014
    Country/TerritoryUnited Kingdom


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