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Epidemiology
Original research
Completeness and validity of alcohol recording in general practice within the UK: a cross-sectional study
  1. Kathryn Mansfield1,
  2. Elizabeth Crellin2,
  3. Rachel Denholm3,
  4. Jennifer K Quint4,
  5. Liam Smeeth1,
  6. Sarah Cook1,
  7. Emily Herrett1
  1. 1 Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
  2. 2 Clinical Practice Research Datalink, London, UK
  3. 3 Centre for Academic Primary Care, University of Bristol, Bristol, UK
  4. 4 Respiratory Epidemiology,Occupational Medicine and Public Health, National Heart and Lung Institute, Imperial College, London, UK
  1. Correspondence to Dr Emily Herrett; emily.herrett{at}lshtm.ac.uk

Abstract

Background Since 2010 the National Institute for Health and Care Excellence has recommended screening adults for excessive alcohol consumption to try and help prevent alcohol-use disorders. Little is known about the extent to which these recommendations are followed, and the resulting completeness and validity of alcohol-related data recording in primary care.

Objective To investigate the completeness and accuracy of recording of alcohol use within primary care records in the UK.

Design and setting Cross-sectional study in the Clinical Practice Research Datalink.

Participants We included all adult patients registered on 1st January 2018 with ≥1 year of follow-up.

Primary and secondary outcome measures We calculated prevalence of alcohol consumption recording overall and within patient groups. We then validated alcohol consumption data against recommended screening tools (Alcohol Use Disorders Identification Test (AUDIT)) as the gold standard. We also calculated how prevalence of alcohol recording changed over the preceding decade.

Results In 2018, among 1.8 million registered adult patients, just over half (51.9%) had a record for a code related to alcohol in the previous 5 years. Recording of alcohol consumption was more common among women, older people, ex-smokers and those from more deprived areas, who were overweight/obese, or with comorbidities. A quarter of patients had units per week recorded in the last 5 years, but <10% had an AUDIT or Fast Alcohol Screening Test (FAST) alcohol screening test score. The recorded alcohol measures corresponded to results from gold standard AUDIT scores. The distribution of consumption among current drinkers was similar to the Health Survey for England.

Conclusions Half of adults in UK primary care have no recorded alcohol consumption data. When consumption is recorded, we have demonstrated internal and external validity of the data, suggesting greater recording may help identify opportunities for interventions to reduce harms.

  • alcohol
  • general practice
  • recording
  • validity
  • screening

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjopen-2019-031537

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    Footnotes

    • KM and EC are joint first authors.

    • Twitter @AnimaSophia, @emilyherrett

    • Contributors EC and KM contributed equally. EH, SC, KM, LS, JKQ, EC and RD contributed to the design of the study. EH and EC extracted the data. EC, KM and EH wrote the statistical programmes and wrote the first draft. All authors (EH, SC, KM, EC, LS, JKQ, RD) contributed to further drafts and approved the final manuscript.

    • Funding EH holds a NIHR postdoctoral fellowship (grant number PDF-2016-09-029). LS received funding from the Wellcome Trust (Grant number 202912/B/16/Z).

    • Disclaimer The NIHR had no role in the design, analysis or writing up of this study.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval This study was approved by the London School of Hygiene and Tropical Medicine Ethics Committee (Approval Number 14454).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data may be obtained from a third party and are not publicly available.