Screening and Intervention Programme for Sensible Drinking (SIPS) National Brief Intervention Research Consortium A&E St. Marys 'Scientia Vincit Timorem

Screening and Intervention Programme Screening and Intervention Programme for Sensible Drinking (SIPS) for Sensible Drinking (SIPS) National Brief Intervention National Brief Intervention

Research ConsortiumResearch Consortium

A&E St. Mary’s 'Scientia Vincit

Timorem'

Training ObjectivesTraining Objectives Content of this session:

Pre-Training Staff Survey

Part 1: Background to the study: Alcohol prevalence, effects and issues in England Hazardous/harmful drinking The AED Trial Alcohol screening and brief interventions The SIPS programme

Parts 2 : Triage Stage Provide you with the knowledge and skills to:

Implement study procedures in accordance with the protocol Introduce the study and gain verbal consent Administer and score the screening questionnaire (FAST)

Part 3: Treating Clinician Stage Obtain consent and check baseline questionnaire Understand requirements of patients involved in the study

Part 4 : Clinical interventions training

Post-Training Staff Survey

Staff surveyStaff survey

This is a short survey on your attitudes towards alcohol This is a short survey on your attitudes towards alcohol screening/brief interventions and relevant pre-training experiencescreening/brief interventions and relevant pre-training experience

Your feedback on the experience of alcohol screening and brief Your feedback on the experience of alcohol screening and brief interventions will make an important contribution to the studyinterventions will make an important contribution to the study

We will ask you to complete the same questionnaire after the We will ask you to complete the same questionnaire after the training session, and once again after recruitment to the study has training session, and once again after recruitment to the study has been completebeen complete

Please read through the Information Sheet and sign two copies of Please read through the Information Sheet and sign two copies of the consent form if you agree to fill it in. the consent form if you agree to fill it in.

Part 1Part 1 – Background – Background

What do you think constitutes an What do you think constitutes an alcohol problem?alcohol problem?

Alcohol Use DefinitionsAlcohol Use Definitions Low-risk drinkingLow-risk drinking - below medically recommended limits (2-3 units - below medically recommended limits (2-3 units

per day for women; 3-4 units per day for men, with at least two per day for women; 3-4 units per day for men, with at least two alcohol free days a week) alcohol free days a week)

Hazardous drinkingHazardous drinking - a pattern of consumption which increases - a pattern of consumption which increases the the riskrisk of harm (physical, psychological or social), i.e., drinking of harm (physical, psychological or social), i.e., drinking above recommended limitsabove recommended limits

Harmful drinkingHarmful drinking - a pattern which is likely to have already led to - a pattern which is likely to have already led to harm (physical, psychological or social) or, for some purposes, harm (physical, psychological or social) or, for some purposes, drinking at “very heavy” levelsdrinking at “very heavy” levels

Binge drinkingBinge drinking – – originallyoriginally episodic heavy drinking but episodic heavy drinking but nownow heavy heavy drinking in a single session, i.e., twice the daily limit, above 6 units drinking in a single session, i.e., twice the daily limit, above 6 units for women 8 units for men for women 8 units for men

Alcohol dependenceAlcohol dependence – a cluster of physiological, behavioural and – a cluster of physiological, behavioural and cognitive phenomena conforming to the “alcohol dependence cognitive phenomena conforming to the “alcohol dependence syndrome”syndrome”

Alcohol use disorders: prevalenceAlcohol use disorders: prevalence

26% of the adult population have an alcohol 26% of the adult population have an alcohol use disorder (AUD)use disorder (AUD)

Includes 38% of men & 16% of women Includes 38% of men & 16% of women aged 16-64aged 16-64

23% of the adult population are hazardous 23% of the adult population are hazardous or harmful alcohol users (7.1 million people or harmful alcohol users (7.1 million people in England)in England)

21% of men and 9% of women engage in 21% of men and 9% of women engage in binge drinkingbinge drinking

Percentage of people in England Percentage of people in England with an alcohol use disorder by agewith an alcohol use disorder by age

Alcohol-related harm: acuteAlcohol-related harm: acute

HomicideHomicide SuicideSuicide Other intentional injuries (i.e., interpersonal Other intentional injuries (i.e., interpersonal

violence)violence) Domestic violenceDomestic violence Sexual assaultSexual assault Unprotected sexUnprotected sex Motor vehicle accidentsMotor vehicle accidents Other accidentsOther accidents DrowningDrowning BurnsBurns Public disorderPublic disorder

Alcohol-related harm: chronicAlcohol-related harm: chronic

Liver cirrhosis and other forms of alcohol-Liver cirrhosis and other forms of alcohol-related liver diseaserelated liver disease

HypertensionHypertension Cancers of the mouth, larynx, pharynx and Cancers of the mouth, larynx, pharynx and

oesophagusoesophagus Other cancers, including breast cancerOther cancers, including breast cancer Foetal Alcohol Syndrome (FAS) and foetal Foetal Alcohol Syndrome (FAS) and foetal

alcohol effectsalcohol effects Mental illnessMental illness Alcohol Dependence SyndromeAlcohol Dependence Syndrome

Alcohol-related harm: social Alcohol-related harm: social problemsproblems

Lower workplace productivityLower workplace productivity UnemploymentUnemployment Family & social networksFamily & social networks HomelessnessHomelessness Economic costsEconomic costs

Alcohol and AEDsAlcohol and AEDs

24 hour prevalence survey of alcohol-related attendances at 32 AEDs in England

40% of AED attendances are alcohol related

Between midnight and 5am this number increases to 70%

Reasons for alcohol related attendance were significantly more commonly:

• a violent assault • incident involving weapons• road traffic accidents• psychiatric emergencies • deliberate self harm episodes

St Mary’s AED TrialSt Mary’s AED Trial

Screening and Brief Interventions for alcohol misuse in Screening and Brief Interventions for alcohol misuse in an accident & emergency department is:an accident & emergency department is:

feasiblefeasible associated with lower levels of alcohol consumption over the associated with lower levels of alcohol consumption over the

following 6 months following 6 months reduces reattendance reduces reattendance

Those referred to the alcohol health worker had a mean Those referred to the alcohol health worker had a mean of 0.5 fewer visits to the AED over the following 12 of 0.5 fewer visits to the AED over the following 12 monthsmonths

For every 2 patients referred to an AHW there is one For every 2 patients referred to an AHW there is one less reattandence in the following year!less reattandence in the following year!

Costs/BenefitsCosts/Benefits

Screening and referral to the AHW has a cost, but this Screening and referral to the AHW has a cost, but this should be offset against the savings gained by reducing should be offset against the savings gained by reducing attendanceattendance

For every 1000 patients screened, costs are For every 1000 patients screened, costs are approximately £2500 (including the cost of the AHW for approximately £2500 (including the cost of the AHW for those referred), and savings of £4000those referred), and savings of £4000

Net: £1500 savingsNet: £1500 savings

Screening for hazardous & Screening for hazardous & harmful drinkingharmful drinking

Screening is necessary to detect risky Screening is necessary to detect risky drinkers whose level of consumption may not drinkers whose level of consumption may not be apparentbe apparent

Short questionnaires are the most efficient Short questionnaires are the most efficient way of screeningway of screening

Screening for hazardous/harmful alcohol Screening for hazardous/harmful alcohol users, not for dependent drinkersusers, not for dependent drinkers

What is brief alcohol What is brief alcohol intervention?intervention?

“… “… the giving of information, advice and encouragement to the giving of information, advice and encouragement to the patient to consider the positives and negatives of their the patient to consider the positives and negatives of their drinking behaviour, plus support and help to the patient if drinking behaviour, plus support and help to the patient if they do decide they want to cut down on their drinking.”they do decide they want to cut down on their drinking.”

““Brief interventions are usually ‘opportunistic’ – that is, they Brief interventions are usually ‘opportunistic’ – that is, they are administered to patients who have not attended a are administered to patients who have not attended a consultation to discuss their drinking”consultation to discuss their drinking”

What is the SIPS ProgrammeWhat is the SIPS Programme

A national research consortium led by the Institute of Psychiatry, A national research consortium led by the Institute of Psychiatry, Kings College London and Newcastle University, with expertise in Kings College London and Newcastle University, with expertise in screening and brief interventions in the alcohol fieldscreening and brief interventions in the alcohol field

Funded by the Department of Health; £3.2 million, as part of the Funded by the Department of Health; £3.2 million, as part of the “Alcohol Harm Reduction Strategy for England” (2004)“Alcohol Harm Reduction Strategy for England” (2004)

To investigate the effectiveness and cost effectiveness of alcohol To investigate the effectiveness and cost effectiveness of alcohol SBI in:SBI in:

Accident & Emergency DepartmentsAccident & Emergency Departments

Primary Health CarePrimary Health Care

Criminal Justice ServicesCriminal Justice Services

Cluster Randomised Cluster Randomised Controlled DesignControlled Design

Within 3 different regions of England – North East, South East and Within 3 different regions of England – North East, South East and London, in:London, in:

24 Primary Health Care practices; 9 Accident & Emergency 24 Primary Health Care practices; 9 Accident & Emergency Departments; 9 probation officesDepartments; 9 probation offices

Cluster = 1 AED, 2-3 PHC sites, 1 probation officeCluster = 1 AED, 2-3 PHC sites, 1 probation office

Study is comparing the effectiveness of:Study is comparing the effectiveness of: 2 screening approaches (targeted vs. universal)2 screening approaches (targeted vs. universal) 3 screening tools (M-SASQ; SIPS-PAT; FAST)3 screening tools (M-SASQ; SIPS-PAT; FAST) 3 brief interventions (PIL; Brief Advice; Brief Lifestyle 3 brief interventions (PIL; Brief Advice; Brief Lifestyle

Counselling)Counselling)

??????????? has been assigned: ??????????? has been assigned: ???????? Screening; ?????; ????????????????? Screening; ?????; ????????? 131 Patients to be recruited at this site131 Patients to be recruited at this site

Objectives of the AED TrialObjectives of the AED Trial

Identify best screening toolIdentify best screening tool Compare effectiveness and cost Compare effectiveness and cost

effectiveness of different models of brief effectiveness of different models of brief interventionintervention

Assess implementation of different Assess implementation of different screening and brief intervention (SBI) screening and brief intervention (SBI) approaches by staffapproaches by staff

Identify factors that predict successful Identify factors that predict successful implementation of SBI in routine AED careimplementation of SBI in routine AED care

Summary of SIPS in your AEDSummary of SIPS in your AED• Assess patient for treatment as normal • Brief introduction of study• Gain verbal consent to check eligibility and screen• Screen for alcohol misuse• If negative end their involvement in the study• If positive hand them a study pack

• Research participant hands over study pack• Staff ensures both consent form is signed by the research participant and then countersigns the forms, giving the patient a copy of this to take away with the information sheet.• Check baseline survey is completed• Issue patient information leaflet and conduct brief structured advice• Store study pack in secure place for SIPS research staff to collect

Triage Stage:

Treating Clinician Stage:

• Research participant hands over study pack• Staff ensures both consent forms are signed by the research participant and then countersigns the forms, giving the patient a copy to retain along with the information sheet.• Check baseline survey is completed• Conduct Brief Advice and issue Patient Information Leaflet• Store study pack in secure place for SIPS research staff to collect

Patient in waiting room to read study pack including: the research participant information sheet, sign both copies of the consent form if they are happy to participate and complete the baseline survey.

Part 2Part 2 – Triage Stage – Triage Stage

Participant Baseline Participant Baseline Questionnaire - AEDQuestionnaire - AED

Introducing the studyIntroducing the study

“ “We are currently working with a team of We are currently working with a team of researchers led by the Institute of Psychiatry, researchers led by the Institute of Psychiatry, who are conducting a study on behalf of the who are conducting a study on behalf of the Department of Health. The aim of the study is to Department of Health. The aim of the study is to find out how to provide help to people who are find out how to provide help to people who are drinking alcohol in ways that might be harming drinking alcohol in ways that might be harming their health. Would you mind if I asked you a few their health. Would you mind if I asked you a few questions to see if you meet the eligibility criteria questions to see if you meet the eligibility criteria to take part in the study, and if you do I would to take part in the study, and if you do I would then like to ask you a few questions about your then like to ask you a few questions about your drinking in the last six months. Would this be drinking in the last six months. Would this be ok?”ok?”

Eligibility criteriaEligibility criteria

The patient: Is aged 18 or over Is alert and orientated i.e. the ability to i.e. the ability to

understand the information presented, retain understand the information presented, retain it and make an informed decision – it and make an informed decision – competencecompetence

Is resident within 20 miles Is able to speak, read and write English

sufficiently well to take part in the study

Recruiting patients to participateRecruiting patients to participate

Eligibility continued...Eligibility continued...

Is not severely injured Is not suffering with a serious mental health problem e.g.

acute psychotic episode or severely distressed Is not grossly intoxicated Is not currently seeking help for alcohol problems Is not involved in any other alcohol research study Has a fixed abode Has provided verbal consent to be screened

Patient demographic informationPatient demographic information

What is a standard unit of alcohol?What is a standard unit of alcohol?

The alcohol screening processThe alcohol screening process

Fast Alcohol Screening Test Fast Alcohol Screening Test (FAST) (FAST)

Examples: Fast Alcohol Examples: Fast Alcohol Screening Test (FAST)Screening Test (FAST)

Most Fridays after work I usually have a couple of pints of Guinness, and then share a bottle of wine over dinner with my wife, followed by a whisky.

Example 1:

In response to question 1 of the FAST, the man says:

1. Calculate the number of standard drinks that the man had: 4 (Guinness) + 4.5 (wine) + 1 (whisky) = 9.5+ standard drinks

2. How would you record and score the answer to this question using the FAST? More than 8 standard drinks every week = weekly

3. Why would you not continue with the remaining 3 questions?He has more than 8 units on one occasion every week = positive. Therefore no need to ask any more questions


I normally have a couple of glasses of wine when I go out, but on my birthday I will get through a whole bottle!

Example 2:

In response to question 1 of the FAST, the woman says:

In response to question 2 she says:

Only a couple times in the last six months . . .

1) How would you score question 1 on the fast?

Less than monthly = not necessarily positive but scores 1 point and you need to ask the other questions

2) How would you record her response on the FAST?‘Less than monthly’ = 1 point


A few times I have missed a class at the gym because of the heavy night before. But this has happened very occasionally – definitely less than monthly.

Example 2 (continued):



Nobody has ever expressed any concern about my drinking habits or suggested that I cut down.

3) How would you record this response?

‘Less than monthly’ = 1 point

4) How would you record this response?

‘No’ = 0 points

5) Would she screen positive or negative using the FAST?

She has 3 points in total so she would be positive


I have a can of beer every evening and then 3 pints when I watch my team play football

Example 3:

In response to question 1 of the FAST, a man says:

1. Calculate the number of standard drinks that the man had: 3 pints = 6 – 9 standard drinks depending on strength of beer

2. How would you record and score the answer to this question using the FAST? Need to ask him how often he watches his team and type of beer he drinks. To which he says:

The wife only lets me out once a month so I only get to watch my team about once a month. I always drink Stella.


Only on my stag night 8 years ago!


3. How would you score his response for question 1 of the FAST? 3 pints Stella = 9 standard drinks one a month: answer would be ‘monthly’.

4. What next?He might not be positive so you give him 2 points and ask the other 3 questions.

5. How would you score his response for question 2 of the FAST? ‘Never’ = 0 points. He therefore still only has 2 points.


6. How would you score his response on question 3 of the FAST? ‘Never’ = 0 points. He therefore still only has 2 points.

It’s never stopped me doing anything as far as I remember.


No, never.


7. How would you score his response on question 4 of the FAST? ‘Never’ = 0 points. Again he still only has 2 points.

8. Would he screen positive or negative?He has only 2 points overall and is negative.

SIPS Modified Paddington SIPS Modified Paddington Alcohol Test (SIPS-PAT) Alcohol Test (SIPS-PAT)

Examples: SIPS-PATExamples: SIPS-PAT

No it was the heels on these new shoes.

Example 1:

A woman presents to the A&E department with injuries from a fall so you screen her using the SIPS-PAT. You ask her if she feels her attendance here is related to her drinking. The woman responds:

So what do you do?

It was not drinking related so you go on to ask the woman question 2 of the SIPS-PAT and you ask her how often she has 6 or more drinks on one occasion. She replies:


When I go out after work I usually have a couple of single vodkas, at the weekend maybe a bit more, say 4 or 5 single vodkas. But never more than that on one occasion.


1) Calculate the number of standard drinks the woman has.4 – 5 standard drinks

2) What box would you cross in question 2?Never

3) Would she screen negative or positive using the SIPS-PAT?Negative


No, it isn’t to do with drink, I tripped on an uneven pavement and hit my head.

Example 2:

A man comes into the A&E department with head injuries so you screen him using the SIPS-PAT. You ask him if he feels his attendance here is related to his drinking. The man responds:

1) So what do you do?

It was not drinking related so you go on to ask the man question 2 of the SIPS-PAT and you ask him how often he has 6 or more drinks on one occasion. He replies:


I go out to the pub most weeks and I usually only drink about 3 pints, very rarely more than that.


2) Calculate the number of standard drinks the man has.6 standard drinks if regular strength beer but more if strong/premium strength so you ask him what pints he normally drinks, he replies:

Kronenbourg, if they’ve got it.

Examples: SIPS-PATExamples: SIPS-PATExample 2 (continued):

3) Taking into account this new information recalculate the number of standard drinks the man has.9 standard drinks

4) What box would you cross in question 2?Weekly

5) Would he screen negative or positive using the SIPS-PAT?Positive


No I fell off a ladder whilst decorating

Example 3:

A man presents to the A&E department with injuries from a fall so you screen him using the SIPS-PAT. You ask him if he feels his attendance here is related to his drinking. The man responds:

So what do you do?

It was not drinking related so you go on to ask the man question 2 of the SIPS-PAT and you ask him how often he has 8 or more drinks on one occasion. He replies:


I usually go out after work and have a couple of pints of Stella and 2 double whiskey and cokes.


1) Calculate the number of standard drinks the man has.2 pints of Stella = 6 standard drinks; Whisky = 4 standard drinks

2) What box would you cross in question 2?Weekly

3) Would he screen negative or positive using the SIPS-PAT?Positive

Modified Single Alcohol Screening Modified Single Alcohol Screening QuestionnaireQuestionnaire

(M-SASQ) (M-SASQ)

Examples: M-SASQExamples: M-SASQExample 1:In response to the M-SASQ question, the man says:

I normally have a glass of wine with dinner most nights, but on a Saturday I have a whole bottle.

1) Calculate the number of standard drinks the man consumes.1-2 units per day and 9 at the weekend

2) What response would you give him on the M-SASQ?weekly

3) Would he screen negative or positive using the M-SASQ?positive

Examples: M-SASQExamples: M-SASQ

Example 2:

In response to the M-SASQ question, the woman says:

I usually drink about 3 or 4 pints on a Friday night after work, but never more than this.

1) Calculate the number of standard drinks the woman has. 6 – 12 standard drinks (depending whether ordinary or strong beer)2) What response would circle on the M-SASQ? Weekly3) Would she screen negative or positive using the M-SASQ? Positive

Examples: M-SASQExamples: M-SASQ

Example 3:

In response to the M-SASQ question, a man says:

I have about 4 beers a night and about 8 on a Saturday night. After all man’s not a camel!

1) Calculate the number of standard drinks the man consumes. 4 beers = 8+ units; 8 beers = 16+; Total = 24+ per week2) What response would you give him on the M-SASQ? Daily3) Would he screen negative or positive using the M-SASQ? Positive

Screening ResultsScreening Results

If patient is If patient is negativenegative, thank them for their interest in the , thank them for their interest in the study and terminate their involvement at this pointstudy and terminate their involvement at this point

If patient is If patient is positivepositive, provide with Research Participant , provide with Research Participant Information Sheet and attempt to obtain written consentInformation Sheet and attempt to obtain written consent

Issuing Research Participant Issuing Research Participant Information SheetInformation Sheet

““II have looked over the results of your questionnaire, and from your have looked over the results of your questionnaire, and from your answers it appears that you may be drinking at a rate that increases answers it appears that you may be drinking at a rate that increases your risk of harm. The research team are trying to find ways of helping your risk of harm. The research team are trying to find ways of helping people who may be drinking in ways that are harmful to health. They people who may be drinking in ways that are harmful to health. They would like about 10 minutes of your time to help with their research, would like about 10 minutes of your time to help with their research, by completing a short questionnaire for which you will receive a £10 by completing a short questionnaire for which you will receive a £10 voucher. You will then receive an voucher. You will then receive an information leaflet [about alcohol] / information leaflet [about alcohol] / and 5 minutes brief advice about alcohol/ and we will arrange an and 5 minutes brief advice about alcohol/ and we will arrange an appointment for you to see an Alcohol Health Worker to discuss your appointment for you to see an Alcohol Health Worker to discuss your drinking further (delete as appropriate)drinking further (delete as appropriate) The research team will contact The research team will contact you again in 6 months and 12 months to complete another short you again in 6 months and 12 months to complete another short questionnaire, for which you will receive another £10 voucher for each questionnaire, for which you will receive another £10 voucher for each time. Please take the time to read this information leaflet carefully, time. Please take the time to read this information leaflet carefully, and feel free to ask any questions you wishand feel free to ask any questions you wish.”.”

AED Research Participant Information SheetAED Research Participant Information Sheet

Part 3Part 3 – Treating Clinician – Treating Clinician StageStage

ConsentConsent Patient will hand baseline pack to clinician who will Patient will hand baseline pack to clinician who will

check consent form.check consent form. Informed consent is an agreement entered into with Informed consent is an agreement entered into with

complete knowledge of all relevant facts. complete knowledge of all relevant facts. Ensure they have read through the consent form Ensure they have read through the consent form

and signed both copies.and signed both copies. If they consent make sure you countersign both If they consent make sure you countersign both

copies and detach patient copy.copies and detach patient copy.

Consent FormsConsent Forms

ConsentConsent If the patient does not consent to participate If the patient does not consent to participate

in the study, offer them the Patient in the study, offer them the Patient Information Leaflet and no further action is Information Leaflet and no further action is taken.taken.

Instructions to patientsInstructions to patients

Patient personal information sheetPatient personal information sheet

Alcohol Use Disorders Identification Alcohol Use Disorders Identification Test (AUDIT)Test (AUDIT)

EQ5D – health status questionnaire EQ5D – health status questionnaire

Service Use Questionnaire (SUQ)Service Use Questionnaire (SUQ)

Readiness to Change Ruler (RCR)Readiness to Change Ruler (RCR)

Please check participants have filled in Please check participants have filled in allall sections of the baseline questionnaire!sections of the baseline questionnaire!

Patient Information LeafletPatient Information Leaflet How Much Is Too Much?How Much Is Too Much?

The Principles of the PILThe Principles of the PIL

an intervention in itselfan intervention in itself contains useful information regarding contains useful information regarding

personalpersonal alcohol use alcohol use is not confrontational or judgmental.is not confrontational or judgmental. free resource for people to take awayfree resource for people to take away easy to read formateasy to read format

How to issue the Patient How to issue the Patient Information Leaflet (PIL)Information Leaflet (PIL)

•Brief Advice and the PIL must be delivered in the same Brief Advice and the PIL must be delivered in the same manner for each patient. manner for each patient. •When handing over the PIL please say:When handing over the PIL please say:

•Thank the patient, inform them they will receive a letter Thank the patient, inform them they will receive a letter from the research team in 2 weeks that will contain a £10 from the research team in 2 weeks that will contain a £10 voucher.voucher.

““This leaflet describes what we have just discussed This leaflet describes what we have just discussed in more detail. Please take this away and read in more detail. Please take this away and read through it. There are contact details on the back through it. There are contact details on the back should you need further help/advice”.should you need further help/advice”.

Pilot DaysPilot Days An opportunity to practice screening and providing Brief AdviceAn opportunity to practice screening and providing Brief Advice

Triage nurse to screen patients and refer those positive to the study Triage nurse to screen patients and refer those positive to the study doctors/ENPsdoctors/ENPs

Doctors/ENPs will have a go at offering the Brief AdviceDoctors/ENPs will have a go at offering the Brief Advice

NoNo research materials will be used research materials will be used

Ensures potential problems can be solved before active recruitment Ensures potential problems can be solved before active recruitment to study beginsto study begins

Sam, Malcolm and Lisa will be on site during pilot for support and Sam, Malcolm and Lisa will be on site during pilot for support and feedbackfeedback

Winchester Flow ChartWinchester Flow Chart

Patient

NO FURTHER ACTION

NO FURTHER ACTION

NEGATIVE, NO FURTHER ACTION

POSITIVE

PIL

THANK YOU LETTER & £10 VOUCHER (within two weeks)

REMINDER LETTER (1 month and a week before 6 month follow up assessment)

6/12 MONTH FOLLOW-UP QUESTIONNAIRES (6 and 12 months after screening)

THANK YOU LETTER & £10 VOUCHER (within one month)

NO

NO

YES

Screening FAST

Obtain informed

written consent

NO

YES

PARTICIPANT BASELINE QUESTIONNAIRE

YES

Inclusion criteria

Research Participant Information Sheet

CONDITION 2: BRIEF ADVICE (BA) AND PIL

Demographic Information

Participant baseline questionnaire – Front page

Introducing the patient to the

study and obtaining verbal

consent

Support and supervisionSupport and supervisionWho to contact if I’m worried about a patient in the study?Who to contact if I’m worried about a patient in the study?

Please contact your alcohol health worker:Please contact your alcohol health worker:

Lisa Rail Lisa Rail Julia ReidJulia ReidTel: 020 7848 5848Tel: 020 7848 5848 Tel: 020 7848 0656Tel: 020 7848 0656Email: Email: [email protected] Email: Email: [email protected]

Or refer patients to alcohol services as outlined in the Patient Information Leaflet:Or refer patients to alcohol services as outlined in the Patient Information Leaflet:

DrinklineDrinklineTel: 0800 917 8282Tel: 0800 917 8282

Alcoholics AnonymousAlcoholics AnonymousTel: 0845 769 7555Tel: 0845 769 7555

Alternatively instruct the patients to contact their GP for referral to local alcohol servicesAlternatively instruct the patients to contact their GP for referral to local alcohol services

Who do I contact if I’m worried about the research processes?Who do I contact if I’m worried about the research processes?In the first instance please contact your designated member of the research team:In the first instance please contact your designated member of the research team:

Sam KeatingSam Keating Malcolm HobbsMalcolm HobbsTel: 020 7848 0437Tel: 020 7848 0437 Tel: 020 7848 0442Tel: 020 7848 0442Email: Email: [email protected] Email:Email:[email protected]

Katherine PerrymanKatherine PerrymanTel: 020 7848 0825Tel: 020 7848 0825Email: Email: [email protected]

Useful linksUseful links

www.sips.iop.kcl.ac.uk/ www.alcoholconcern.org.uk www.dh.gov.uk www.nhs.uk

Documents

Screening and Intervention Programme for Sensible Drinking (SIPS) National Brief Intervention Research Consortium A&E St. Marys 'Scientia Vincit Timorem