Screening questionnaires to identify problem drinking in the primary care setting: a systematic review

Aim: Guidance on screening instruments is lacking. Early recognition of harmful drinking patterns is of socio-economic importance for health policies. Aim of this systematic review was to investigate the validity and reliability of alcohol screening questionnaires to identify problem drinking as a secondary prevention measure. Subject and methods: About eight million people live in Austria and approximately 360,000 are diagnosed with chronic alcoholism. In 2011, the direct medical cost for alcohol-related diseases was 374 million Euros. The hazardous effects of excessive drinking and the problems caused by alcohol are frequently documented. A systematic search of the literature was conducted in online databases between September and December 2014. Inclusion criteria included the use of alcohol-screening instrument compared to a gold standard, primary care setting, and adults over 18 years. Results: Eight diagnostic accuracy studies and three systematic reviews were included in this review. The reviewed scientific literature demonstrates the validation of five alcohol-screening instruments plus their abbreviated versions that are currently available in German-speaking countries. Those instruments are suitable for primary care depending on the validated setting. Conclusion: Primary healthcare workers do not routinely screen for harmful drinking in their usual practice in German-speaking countries. Brief interventions are initiated based on results of screening tests; hence, the opportunity for brief interventions is missed. However, guidance and training on validated alcohol-screening instruments and information on the content of brief interventions is currently missing in German-speaking countries. © 2015, Springer-Verlag Berlin Heidelberg.