Patient versus Proxy - Alcohol Intake

• Research type

  Research Study

• Full title

  Investigation into the use of a proxy for alcohol history for patients in intensive care using the Adult Use Disorders Identification Test (AUDIT).

• IRAS ID

  162929

• Contact name

  Charlotte Soulsby

• Contact email

  charlotte.soulsby@glasgow.ac.uk

• Sponsor organisation

  NHS Greater Glasgow & Clyde

• Duration of Study in the UK

  0 years, 9 months, 0 days

• Research summary

  The aim of this study is to address assessment of alcohol intake in intensive care patients. It will investigate whether intensive care patients’ self-evaluation of alcohol intake correlates with that of a proxy evaluation of alcohol intake. As it is often difficult to communicate verbally with ventilated or sedated patients obtaining an accurate history is challenging. A patient proxy will be approached to complete the ten question Alcohol Use Disorders Identification Test (AUDIT), answering as if they were the patient (1). This screening tool assesses drinking behaviours and pattern, categorising alcohol intake into three categories – hazardous drinking, harmful drinking or alcohol dependence (1). Hazardous drinking increases the risk of harmful consequences for the user (1). Harmful use refers to alcohol use resulting in physical and mental health consequences (1). Following discharge from intensive care the patient will answer the same AUDIT questions. If the proxy is found to be a reliable collateral informant then this information can enable identification and treatment of those patients most at risk from alcohol withdrawal.
  A significant proportion of intubated patients develop delirium – resulting in excess sedation and long term cognitive impairment (2,3). Once patients enrolled in the study are discharged from intensive care they will be screened for delirium and cognitive impairment using the 4'A's Test (4AT): screening instrument for delirium and cognitive impairment to assess competency for consent and completion of the AUDIT tool (4).
  This study will run over nine months and recruit patients admitted to intensive care in Glasgow Royal Infirmary, excluding those who are under sixteen, do not have a proxy over sixteen or die before discharge from intensive care.
  References
  1.Saunders JB et al. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption – II. Addiction. 1993;88:791-804.
  2.Jones SF and Pisani MA. ICU delirium: an update. Curr Opin Crit Care 2012, 18:146-151.
  3.Milbrandt EB et al. Costs associated with delirium in mechanically ventilated patients. Crit Care 2004; 32:955-962.
  4.MacLullich A. The 4 'A's Test: screening instrument for delirium and cognitive impairment. Available: http://www.the4at.com/. Last accessed 05/09/2014

• REC name

  West of Scotland REC 3

• REC reference

  15/WS/0014

• Date of REC Opinion

  19 Feb 2015

• REC opinion

  Further Information Favourable Opinion