Resources for the Comprehensive Geriatric Assessment based
Proactive and Personalised Primary Care of the Elderly
AUDIT + AUDIT - C
Alcohol Use Disorders Identification Tool
AUDIT - Consumtion
Purpose : Screening tool to identify people who are at risk of developing alcohol problems
Admin time : 10 min
User Friendly : High
Administered by : GP or nurse
Content : Questions pertaining to alcohol use and abuse.
Author : (Saunders JB, 1993)
The Alcohol Use Disorders Identification Test (AUDIT) was developed by the World Health Organization (Saunders JB, 1993) as a simple way to screen and identify people who are at risk of developing alcohol problems.
The AUDIT test focuses on identifying the preliminary signs of hazardous drinking and mild dependence.
It is used to detect alcohol problems experienced within the last year.
It is one of the most accurate alcohol screening tests available, rated 92 percent effective in detecting hazardous or harmful drinking, and has proven to be accurate across all ethnic and gender groups.
The test contains 10 multiple choice questions on quantity and frequency of alcohol consumption, drinking behavior and alcohol-related problems or reactions.
The answers are scored on a point system. A score of more than eight indicates an alcohol problem.
The AUDIT-C is a shortened version of the AUDIT tool using the first 3 questions only (Bush K, 1998).
Using a cut-off ≥4 the Audit-C has a sensitivity of 86% of patients with heavy drinking and/or active alcohol abuse or dependence, with a specificity of 72%.
Using a cutoff of ≥3, AUDIT-C identifies 90% of patients with active alcohol abuse or dependence and 98% of patients with heavy drinking.
Specificity = 60%, false-positive rate = 40% (Dawson DA, 2010).
It is recommended a score of ≥3 or more points on the AUDIT-C,
or a report of drinking 6 or more drinks on one occasion ever in the last year,
should lead to a more detailed assessment of drinking and related problems by completion of the full questionnaire (Bradley KA, 2007).
Clients with positive AUDIT-C scores (3 or more for men, and 4 or more for women) will benefit from further assessment and/or intervention.
This can be addressed in several ways, such as:
- Review alcohol intake over the past few months to confirm accuracy, including details of intake for each day in the past week to determine whether typical drinking is within recommended limits.
Ask the client: Has this been your consistent pattern over the past 2 - 3 months?
- Assess size of drinks and type(s) of beverage(s).
- Review the client's medical history and medication list for contraindications to drinking.
- Ask if the client has a history of Hepatitis C, prior alcohol treatment, prior alcohol or substance use disorder diagnosis, is attempting to conceive, or is pregnant.
- Counsel clients to cut down if they exceed recommended limits, and educate them about the link between alcohol use and health.
- Communicate recommended limits and counsel the client to always drink below those limits. Make sure to define standard drink sizes.
These Tools are used in the assessment of
Back To : Alcohol Problems
Back To : Thorny Issues
This is one of several topics presented in the Thorny Issues sector of this toolkit