A mixed-methods evaluation of an intervention for enhancing alcohol screening in adults aged 50+ attending primary health care

Andy Towers; David Newcombe; Gillian White; John McMenamin; Janie Sheridan; Juma Rahman; Alison Moore

doi:10.1071/HC24061

RESEARCH ARTICLE (Open Access)

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A mixed-methods evaluation of an intervention for enhancing alcohol screening in adults aged 50+ attending primary health care

Andy Towers

¹ ^* , David Newcombe ² ³ , Gillian White ⁴ , John McMenamin

⁴ , Janie Sheridan ² ³ , Juma Rahman ² , Alison Moore ⁵

+ Author Affiliations

- Author Affiliations

¹ School of Health Sciences, College of Health, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand.

² Centre for Addiction Research, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand.

³ School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand.

⁴ Health and Research Collaborative Whanganui, 190 Wicksteed Street, Whanganui, 4500, New Zealand.

⁵ Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California San Diego, USA.

^* Correspondence to: A.J.Towers@massey.ac.nz

Handling Editor: Tim Stokes

Journal of Primary Health Care https://doi.org/10.1071/HC24061

Submitted: 15 July 2024 Accepted: 6 December 2024 Published: 2 January 2025

© 2025 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

Adults aged 50 years and over are drinking more than ever but primary health care (PHC) professionals find it challenging to screen them for alcohol-related harm, despite being at greater risk for harm than younger drinkers.

Aim

This intervention aimed to enhance alcohol screening for this cohort by (a) introducing an algorithm in the patient management system to automate detection of alcohol risk in patients and (b) providing training to support health professionals' practice of, knowledge about, and comfort with alcohol screening in this cohort.

Methods

Eleven PHC practices in Aotearoa New Zealand took part in this intervention, including 41 PHC health professionals. Development and integration of the automated alcohol screening process within PHC patient management systems was undertaken in parallel with health professional training approaches.

Results

Screening rates increased substantially at intervention initiation but fell immediately with the onset of the New Zealand COVID-19 national lockdown. Two-thirds of health professionals identified the system screening prompts, over 40% felt this changed their screening practice, and 33% increased their awareness of – and felt more comfortable screening for – alcohol-related risk in those aged 50+.

Discussion

We illustrated an initial increase in alcohol screening rates in those aged 50+ as a result of this intervention, but this increase could not be sustained in part due to COVID-19 disruption. However, health professionals indicated that this intervention helped many change their practice and enhanced their awareness of such risk and comfort in screening for alcohol-related risk in those aged 50+.

Keywords: Ageing, Alcohol, General practitioners, Primary health care, Professional education, Screening.

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