Evidence
Surveillance decision
We will not update the guideline on alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (NICE guideline CG115).
We will update the guideline on alcohol-use disorders: prevention (NICE guideline PH24). Areas indicated for update are:
-
screening children and young people aged 10 to 15 years, and 16 and 17 years (recommendations 6 and 7)
-
brief advice and extended brief interventions in adults (recommendations 10 and 11).
The following table gives an overview of how evidence identified in surveillance might affect each area of the guideline on alcohol-use disorders: prevention, including any proposed new areas.
|
Section of the NICE guideline |
New evidence identified |
Impact |
|
Recommendation 4: licensing |
Yes |
No |
|
Recommendation 5: resources for screening and brief interventions |
Yes |
No |
|
Recommendation 6: supporting children and young people aged 10 to 15 years |
Yes |
Yes |
|
Recommendation 7: screening young people aged 16 and 17 years |
Yes |
Yes |
|
Recommendation 8: extended brief interventions with young people aged 16 and 17 years |
Yes |
No |
|
Recommendation 9: screening adults |
Yes |
No |
|
Recommendation 10: brief advice for adults |
Yes |
Yes |
|
Recommendation 11: extended brief interventions for adults |
Yes |
Yes |
|
Recommendation 12: referral |
Yes |
No |
Reasons for the decision
This section provides a summary of the areas that will be updated and the reasons for the decision to update.
Alcohol-use disorders: prevention (NICE guideline PH24)
Recommendation 6: supporting children and young people aged 10 to 15 years and recommendation 7: screening young people aged 16 and 17 years
New published evidence indicates that an AUDIT-C threshold of 3 may be helpful in identifying at-risk alcohol use in young people aged 10 to 17 years, and an AUDIT score of 7 was more effective at identifying alcohol dependence. This evidence could be used to provide greater clarity on screening thresholds in young people aged 10 to 17 years and could change the recommendations – currently the guideline advises using professional judgement as to whether to revise the AUDIT scores downwards when screening younger people (under the age of 18).
Recommendation 10: brief advice for adults
There has been a large amount of new evidence published on brief advice for adults in various settings and delivered by different practitioners and to different populations. The published evidence indicates that the effectiveness of brief advice is modified by the setting, delivery practitioner and population receiving the advice. Topic expert feedback also highlighted that not all settings should be delivering brief advice, and resources should focus on those settings where it has been proven to be effective. Given this new evidence, the guideline recommendation on brief advice for adults may need updating.
Recommendation 11: extended brief interventions for adults
New published evidence on extended brief interventions indicates that interventions may not be effective in all populations and settings. Currently the NICE guideline recommends offering extended brief interventions to all adults who have not responded to brief advice, but does not specify the setting or populations to target. Given this new evidence, the guideline recommendations on extended brief interventions for adults may need updating.
For further details and a summary of all evidence identified in surveillance, see appendix A1.
Alcohol-use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence (NICE guideline CG115)
We propose to not update this guideline. The reason for not updating it at this time is that newly published evidence was not deemed sufficient to change current recommendations and further evidence is needed, particularly around digital interventions for alcohol misuse, and pharmacotherapies for managing mild alcohol dependence, assisted withdrawal, and following successful withdrawal.
For further details and a summary of all evidence identified in surveillance, see appendix A2.
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