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Lookup NU author(s): Dr Amy O'DonnellORCiD,
Dr Katie Haighton,
Dr David Chappel,
Professor Eileen KanerORCiD
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Background: UK health policy has sought to encourage alcohol screening and brief intervention (SBI) delivery in primary care, including via the introduction of pay-for-performance (P4P) schemes in 2008. In order to measure the impact of such policies, a range of data exist, including General Practitioner (GP) Read codes which record all clinical activity. Research question: Can routinely recorded Read code data help evaluate the implementation of alcohol SBI in primary healthcare?Method: Sequential mixed methods design: descriptive statistical analysis of alcohol Read code data by systematically interrogating 16 GP practice IT systems in North East England; followed by 10 in-depth GP interviews to explore factors influencing recording behaviourResults: 287 alcohol-related Read codes existed, however only 40 (13.9%) were used between 2007-11, generally relating to the recording of a patient’s alcohol consumption status, BI delivery and screening tool administration (57.6%, 34.9% and 7.2% respectively of all codes used 2007-11). Further, many of the 287 available Read codes related to relatively rare alcohol conditions (52.2%) or duplicate/outmoded terminology (31%). Use of formal screening tools was rare pre-2008, but rates increased steadily after this point. In 2010-11 practices with higher SBI recording rates were typically signed up to P4P schemes (e.g. screening rates ranged from 3.73% (CI: 3.65-3.89) in P4P practices to 0.05% (CI: 0.03-0.08) in non-P4P practices (p <0.00)). However, GP interviews suggested that nurse-led SBI was most likely to be coded and delivered consistently, whilst GP delivery of SBI was more ad hoc, with a strong reliance on weekly alcohol consumption measures rather than validated screening tools to assess risk.Conclusions: Whilst routine data may detect more successfully embedded screening activity in primary care post-2008, measuring SBI delivery remains challenging, particularly for GPs.
Author(s): O'Donnell A, Haighton K, Chappel D, Shevills C, Kaner E
Publication type: Conference Proceedings (inc. Abstract)
Publication status: Published
Conference Name: 36th Annual Scientific Meeting of the Research Society on Alcoholism
Year of Conference: 2013
Publisher: Research Society on Alcoholism