Pioneer doc's anti booze bid | Manawatu-Wanganui News | Local News in Manawatu-Wanganui

Pioneering work done by Wanganui GPs is on the verge of being rolled out across the country.

And tonight Dr John McMenamin, of Wicksteed Medical Centre in the city, will be outlining the programme to his peers at the NZ Royal College of General Practitioners conference in Christchurch.

The computer-based programme makes it far easier to screen patients for possible alcohol problems and at the same time makes follow-up support care simpler.

Dr McMenamin devised the programme which is based on the highly successful programme which has helped people quit smoking.

Work pressures on GPs made it difficult to maintain a systematic screening and monitoring of alcohol risk and problem drinking but Dr McMenamin has simply modelled his programme on similar programmes that dealt with helping people stop smoking.

International studies show brief interventions have a positive effect on reducing alcohol consumption and associated health and social factors.

His programme uses a similar ABC approach which is to "ask" the patient about their smoking, provide "brief" intervention and offer "counselling" support to help the patient quit smoking.

The Alcohol Advisory Council of New Zealand (ALAC) learned of Wanganui's success with the smoking programme and asked Dr McMenamin if he could devise a similar programme targeting alcohol use.

In the alcohol programme, ABC stands for "ask" about alcohol, offer "brief" intervention and refer people at highest risk for "counselling".

Dr McMenamin said the software raises a flag on a patient's record if they have not been questioned about their alcohol use. Initially the patient is asked three questions about their frequency of alcohol consumption, the amount they consume per drinking session and how often they have more than six drinks at any one time.

If the patient's answers indicate consumption above ALAC's nationally accepted guidelines for risky drinking, the programme automatically opens a further questionnaire known as the alcohol use disorder identification test (AUDIT). This scores the patient according to their risk of harm from excessive drinking.

People whose drinking is placing them at risk would receive brief intervention in the form of individually tailored education. People with alcohol dependency would be referred to an alcohol specialist nurse or specialist alcohol counsellor for support.

He said his address to the conference tonight will advise other GPs around the country that the ABC approach can be adapted into the alcohol area.

"It's really about normalising things for the patients and it's also encouraging patients to be willing to engage in a conversation with their GP or practice nurses"

He said in the Wanganui district about 30 per cent of patients had shown up some alcohol issues which had been addressed by the general practice in some way.

"It's letting people see alcohol use as a health issue and this programme gives an entry point into discussing it with our patients.

"While it's important we have legislation surrounding alcohol, we need a way for individuals to address the issues they may have and this programme lets us."

The pilot started in February this year, initially with the five GPs working at Wicksteed Medical Centre and the seven doctors at the Aramoho Health Centre, before it was rolled out to all 35 practices in WRPHO area.

HOW IT WORKS

Dr McMenamin's pilot programme reminds GPs and practice nurses to ask patients about alcohol use and uses a computer prompt to get the GP or nurse to:

• Ask all patients about their alcohol consumption and document this.
• Patients identified as drinking over safe levels are assessed using the computerised AUDIT questionnaire and offered brief advice.
• If appropriate, patients are referred for nurse or specialist alcohol counselling.