Completeness and validity of alcohol recording in general practice within the UK: a cross-sectional study
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Author(s)
Type
Journal Article
Abstract
Background: Since 2010 the National Institute for Health and Care Excellence has recommended screening adults for excessive alcohol consumption to try and help prevent alcohol-use disorders. Little is known about the extent to which these recommendations are followed, and the resulting completeness and validity of alcohol-related data recording in primary care.
Objective: To investigate the completeness and accuracy of recording of alcohol use within primary care records in the UK.
Design and setting: Cross-sectional study in the Clinical Practice Research Datalink
Participants: We included all adult patients registered on 1st January 2018 with ≥1 year of follow-up.
Primary and secondary outcome measures: We calculated prevalence of alcohol consumption recording overall and within patient groups. We then validated alcohol consumption data against recommended screening tools (AUDIT) as the gold standard. We also calculated how prevalence of alcohol recording changed over the preceding decade.
Results: In 2018, among 1.8 million registered adult patients, just over half (51.9%) had a record for a code related to alcohol in the previous five years. Recording of alcohol consumption was more common among women, older people, ex-smokers, and those from more deprived areas, who were overweight/obese, or with comorbidities. A quarter of patients had units per week recorded in the last five years, but <10% had an AUDIT or FAST alcohol screening test score. The recorded alcohol measures corresponded to results from gold standard AUDIT scores. The distribution of consumption among current drinkers was similar to the Health Survey for England.
Conclusions: Half of adults in UK primary care have no recorded alcohol consumption data. When consumption is recorded, we have demonstrated internal and external validity of the data, suggesting greater recording may help identify opportunities for interventions to reduce harms.
Objective: To investigate the completeness and accuracy of recording of alcohol use within primary care records in the UK.
Design and setting: Cross-sectional study in the Clinical Practice Research Datalink
Participants: We included all adult patients registered on 1st January 2018 with ≥1 year of follow-up.
Primary and secondary outcome measures: We calculated prevalence of alcohol consumption recording overall and within patient groups. We then validated alcohol consumption data against recommended screening tools (AUDIT) as the gold standard. We also calculated how prevalence of alcohol recording changed over the preceding decade.
Results: In 2018, among 1.8 million registered adult patients, just over half (51.9%) had a record for a code related to alcohol in the previous five years. Recording of alcohol consumption was more common among women, older people, ex-smokers, and those from more deprived areas, who were overweight/obese, or with comorbidities. A quarter of patients had units per week recorded in the last five years, but <10% had an AUDIT or FAST alcohol screening test score. The recorded alcohol measures corresponded to results from gold standard AUDIT scores. The distribution of consumption among current drinkers was similar to the Health Survey for England.
Conclusions: Half of adults in UK primary care have no recorded alcohol consumption data. When consumption is recorded, we have demonstrated internal and external validity of the data, suggesting greater recording may help identify opportunities for interventions to reduce harms.
Date Issued
2019-11
Date Acceptance
2019-10-04
Citation
BMJ Open, 2019, 9 (11)
ISSN
2044-6055
Publisher
BMJ Journals
Journal / Book Title
BMJ Open
Volume
9
Issue
11
Copyright Statement
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Subjects
alcohol
general practice
recording
screening
validity
1103 Clinical Sciences
1117 Public Health and Health Services
1199 Other Medical and Health Sciences
Publication Status
Published
Article Number
e031537
Date Publish Online
2019-11-26