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13. Resources

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Glossary

TermDefinition
Alcohol misuse

Drinking more than 14 units of alcohol per week.

Brief advice or brief intervention

A brief intervention, sometimes called ‘brief advice’, is a short, structured conversation about alcohol consumption or another lifestyle behaviour.

FRAMES

FRAMES is an acronym summarising the components of a brief intervention. Feedback (on the client's risk of having alcohol problems), responsibility (change is the client's responsibility), advice (provision of clear advice when requested), menu (what are the options for change?), empathy (an approach that is warm, reflective and understanding) and self-efficacy (optimism about the behaviour change).

Harmful drinking behaviour

Harmful drinking behaviour is defined as men who regularly drink more than 50 units a week and women who regularly drink more than 35 units per week.

Hazardous drinking behaviour

Hazardous drinking behaviour is defined as men who drink over 14 units and up to 50 units per week and women who drink over 14 units and up to 35 units per week.

Referral to treatment

For patients with higher levels of alcohol consumption or who are alcohol dependent, it may be necessary to refer them for more extensive and longer-term interventions provided by other hospital departments, GPs or local services and support groups. Discussing the patient’s preferred option with them may help to refer them to the right kind of support.

SBIRT

SBIRT means screening, brief intervention and referral to treatment.

Screening

Screening refers to the rapid assessment of a patient’s drinking behaviour and identification of the advice or treatment that might be needed to help them reduce their alcohol consumption.

Unit of alcohol

In the UK, alcoholic drinks are measured in units. One unit corresponds to approximately 8g or 10ml of ethanol.

Urgent and emergency care settings

Urgent and emergency care settings include, but are not limited to, emergency departments, urgent care centres, minor injury units and walk-in centres.

Resources

Resource TitleDescription
Alcohol Change UK

Website providing facts and support relating to alcohol.

Alcohol Change UK - patient tools

Online tool to help patients check their drinking levels.

Alcohol consumption: advice on low risk drinking

UK Chief Medical Officers' guidelines on how to keep health risks from drinking alcohol to a low level.

Alcohol Screening Tests

Alcohol use screening tests are provided which can be used by health professionals as a tool to assess a service users level of risk to alcohol harm. Provided by Public Health England.

Alcohol unit and calorie calculator

Unit and Calorie Calculator which will work out the number of alcohol units and calories consumed.

Alcohol units

Facts about alcohol including links to a calculator to work out how many units are in different alcoholic drinks.

Alcohol use screening tests

This resource provides the alcohol use screening tests which can be used by health professionals as a tool to assess a service users level of risk to alcohol harm.

Australian Government Alcohol Resources

Information about the impact of alcohol, the Australian guidelines for how much it is safe to drink and tips for reducing or quitting alcohol consumption.

Briefing Paper Delivering Alcohol Brief Advice

Published by Public Health Wales (2010) and written by Su Mably (Consultant in Public Health) and Craig Jones (Public Health Practitioner) this briefing paper provides a comprehensive guide for practitioners in delivering brief interventions on alcohol use. The paper introduces practitioners to key terms relating to brief advice, provides background information, describes the evidence based approach to brief advice, provides suggestions for having the conversation with patients and provides answers to some frequently asked questions.

Centers for Disease Control Alcohol and Public Health

Information about alcohol use statistics in the US, impact on health, guidelines for safe consumption and interventions.

Drinkaware Alcohol Brief Interventions

Practical guidance on delivering brief interventions and the evidence to support them, plus online training resources.

Drinkaware Health Practitioner Resource Centre

Resources for health professionals including practical guidance and tools to promote alcohol awareness with patients. Includes guidance on how to have the conversation about alcohol with patients, resources to promote alcohol awareness and online support tools to help patients reduce their drinking.

Drinkaware Tools for Patients

Online tools to help patients assess, track and set goals to reduce their drinking.

E-learning for health: Alcohol and Tobacco Brief Interventions / Alcohol identification and Brief Advice

This resource provides several training modules related to alcohol brief advice in primary care and hospital settings. NB: This is a UK based website which requires a login and password. If you work for the UK National Health Service or an associated organisation you may be able to access these resources, however they may not be accessible to everyone. .

Effectiveness of brief alcohol interventions in primary care populations

A systematic review of brief alcohol interventions in primary care populations, written by Kaner EFS, Beyer FR, Muirhead C, Campbell F, Pienaar ED, Bertholet N, Daeppen J, Saunders JB, Burnand B (2018) Cochrane Reviews.

Global Strategy to Reduce the Harmful Use of Alcohol

During the Sixty-third session of the World Health Assembly, held in Geneva in May 2010, the 193 Member States of WHO reached an historical consensus on a global strategy to reduce the harmful use of alcohol by adopted resolution WHA63.13. Work is now underway to develop the action plan (2022 - 2030) to effectively implement the Global strategy to reduce the harmful use of alcohol.

Hester RK, Miller WR. Handbook of Alcoholism Treatment Approaches. 2 ed. Boston, MA: 1995

FRAMES approach (i.e. Feedback, Responsibility, Advice, Menu of options, Empathy, Self-efficacy).

Local alcohol profiles for England (LAPE)

The aim of LAPE is to provide information for local government, health organisations, commissioners and other agencies to monitor the impact of alcohol on local communities, and to monitor the services and initiatives that have been put in place to prevent and reduce the harmful impact of alcohol. The tool allows you to compare a local authority against other local authorities in the region and benchmark the local authority against the England or regional average..

Making every contact count (MECC)

Making every contact count (MECC) is an approach to behaviour change that utilises the millions of day to day interactions that organisations and people have with other people to encourage changes in behaviour that have a positive effect on the health and wellbeing of individuals, communities and populations (e.g. in relation to tobacco, hypertension, alcohol, being overweight or being physically inactive). This website provides resources and information to support people and organisations implementing MECC and has been developed with multi-agency input at local, regional and national level.

National Organisation for FASD - Information about alcohol in pregnancy

This website provides information about alcohol in pregnancy and Foetal Alcohol Spectrum Disorder (FASD).

NICE PH24 Alcohol use disorders: Prevention

This guideline covers alcohol problems among people over 10 and provides guidelines for policy and practice for delivering brief interventions.

Public Health England (2016) The Public Health Burden of Alcohol and the Effectiveness and Cost-Effectiveness of Alcohol Control Policies An evidence review

This review provides an overview of alcohol-related harm in England and possible policy solutions. The report offers a broad and rigorous summary of the types and prevalence of alcohol-related harm, and evidence for the effectiveness and cost-effectiveness of alcohol control policies. The findings are interpreted within the English context and will be relevant to academics and researchers, public health professionals and policymakers in the health and non-health sectors.

Public Health England's Alcohol Structured Advice Tool

Information leaflet about alcohol.

Royal College of Emergency Medicine Alcohol Toolkit (2015)

This toolkit aims to promote best practice in alcohol management, advance safe and effective care in this area and educate and train emergency care practitioners.

Royal College of Obstetricians and Gynaecologists Information Sheet on Alcohol and Pregnancy

This website provides information for patients who are pregnant or planning to have a baby about the impact of alcohol on the development of the baby.

The Medical Council on Alcohol

An independent charity of health professionals which aims to improve the understanding and management of alcohol-related health. Includes education, a journal, an annual symposium, policy and support.

World Health Organisation Alcohol Factsheet

A factsheet outlining the global impact of alcohol consumption.

Learning outcomes

By completing this resource, you should have developed:

  • knowledge, confidence and skills in screening, brief intervention and referral for treatment (SBIRT) for alcohol prevention in an urgent and emergency care setting

To meet this learning objective, the resource has provided opportunities to learn about:

  • the impact of alcohol on individuals and within society
  • the role of urgent and emergency care settings in alcohol prevention

Through exploring how to:

  • assess patients' alcohol consumption
  • deliver brief advice to patients
  • decide when to refer patients for further support or treatment

This resource was developed by:

Project Leads: University of Nottingham: Dr Emma Adams and Prof Holly Blake

DREEAM, Nottingham University Hospitals Trust: Prof Frank Coffey, Dr Philip Miller, Lucy Morris, Goolnora Marshall


Health e-Learning & Media (HELM) team: Gill Langmack, Michael Taylor and Lydia Jones
This resource was developed using HELM’s ASPIRE methodology. Content was developed in consultation with, and peer reviewed by, experts in several areas of health and care, including nursing, medicine, public health or emergency medicine research, and community health protection services (i.e., substance misuse, smoke-free).


Citation: This learning resource has been developed by the University of Nottingham in partnership with DREEAM (Department of Research and Education: Emergency Medicine, Acute Medicine, Major Trauma) and the Emergency Department at Nottingham University Hospitals NHS Trust. If you distribute this resource, or refer to information within it, please attribute this to the developers and use the following citation:

Adams, E.J., Miller P., Coffey, F., Morris, L., Marshall, G. and Blake, H. Alcohol prevention in urgent and emergency care settings. The University of Nottingham and Nottingham University Hospitals NHS Trust. Version 1. [09/09/22]


Please see details of the development and evaluation processes here: Blake, H.; Adams, E.J.; Chaplin, W.J.; Morris, L.; Mahmood, I.; Taylor, M.G.; Langmack, G.; Jones, L.; Miller, P.; Coffey, F. Alcohol Prevention in Urgent and Emergency Care (APUEC): Development and Evaluation of Workforce Digital Training on Screening, Brief Intervention, and Referral for Treatment. Int. J. Environ. Res. Public Health 2023, 20, 7028. https://doi.org/10.3390/ijerph20227028


Technical development: Technical development was carried by Mike Taylor with pedagogical input from Gill Langmack from the Health e-Learning and Media Team (HELM) at the University of Nottingham.


Narration: Sala Kamkosi Khulumula, Critical Care Nurse & Vaccinator, UK/Malawi.


Videos and Podcasts:

  • Justin Greenwood, Patient and Public Involvement Representative, UK
  • Goolnora Marshall, Nurse, Nottingham University Hospitals NHS Trust, UK
  • Lucy Morris, Nurse, Nottingham University Hospitals NHS Trust, UK
  • Clive Hallam, Patient Actor, UK
  • Technical team: Lydia Jones and Mike Taylor, HELM Team.

Peer-review panel:

  • Dr Andrew Beckham, Lead Undergraduate Education Programme, Emergency Department, Nottingham University Hospitals NHS Trust, UK
  • Dr Lucie Cocker, Emergency Medicine CT3, Emergency Department, Nottingham University Hospitals NHS Trust, UK
  • Traci Hudson, Assistant Professor, University of Nottingham, UK
  • Justin Greenwood, Patient and Public Involvement Representative, UK
  • Dr Basharat Hussain, Sociologist, Lahore, Pakistan
  • Zahida Niazi, Smokefree Lead, Nottingham University Hospitals NHS Trust, UK
  • Dr Noureen Shivji, Research Associate Health Services Research, Keel University, UK
  • Dr Rachel Tricks, Nottingham University Hospitals NHS Trust, UK
  • Dr Katharine Whittingham, Assistant Professor, University of Nottingham, UK
  • Dr Joanne Ollerton, Emergency Medicine Consultant, Emergency Department, Nottingham University Hospitals NHS Trust, UK
  • Ryan Branigan, Deputy Charge Nurse, Emergency Department, Nottingham University Hospitals NHS Trust, UK
  • Amy Clark, Senior Research Practitioner, Emergency Department, Nottingham University Hospitals NHS Trust, UK

Funding: Funding to support the development of this resource was provided by Nottingham Hospitals Charity.

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