Standardised alcohol screening in primary health care services targeting Aboriginal and Torres Strait Islander peoples in Australia

Authors

M Islam, La Trobe University
Helen Oni, La Trobe University
K Lee, Indigenous Health and Alcohol, University of Sydney
Noel Hayman, Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, University of Queensland, Griffith University
Scott Wilson, Aboriginal Drug and Alcohol Council, University of Sydney
Kristie Harrison, University of Sydney
Beth Hummerston, Aboriginal Health Council of South Australia Ltd
Rowena G. Ivers, Illawarra Aboriginal Medical Service, University of WollongongFollow
Kate M. Conigrave, Indigenous Health and Alcohol, University of Sydney, Sydney Local Health DistrictFollow

RIS ID

126714

Publication Details

Islam, M. Mofizul., Oni, H. T., Lee, K. Kylie., Hayman, N., Wilson, S., Harrison, K., Hummerston, B., Ivers, R. & Conigrave, K. M. (2018). Standardised alcohol screening in primary health care services targeting Aboriginal and Torres Strait Islander peoples in Australia. Addiction Science & Clinical Practice, 13 (5), 1-11.

Abstract

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 Identifcation 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 staf. Help was often required with converting consumption into standard drinks. Researchers commented that AUDIT and its short forms prompted refection 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 ofers 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