Alcohol use: risk assessment for people with depression or anxiety

Indicator type

General practice indicator suitable for use in the Quality and Outcomes Framework.

Rationale

Alcohol is a cause of significant public health burden but use is widespread amongst most groups of society. Alcohol is the leading cause of ill-health, early mortality and disability in those aged 15 to 49 years of age (see NHS Digital's 2017 statistics on alcohol). Harmful drinking is associated with multiple physical and mental health problems.

Alcohol misuse contributes to 200 health conditions including depression. It is sometimes used to manage symptoms of anxiety and depression but is likely to make those symptoms worse. In 2017/18 there were 37,285 admission episodes for mental and behavioural disorders due to the use of alcohol (see Public Health England's Alcohol profile 2019).

Managing alcohol intake can help to manage symptoms in those with anxiety and depression. This indicator aims to identify people with depression or anxiety who are at risk of hazardous alcohol consumption. Tools such as AUDIT‑C and FAST can help to identify people that may not be alcohol dependent but would benefit from an reducing their alcohol consumption.

Source guidance

Alcohol-use disorders: prevention. NICE guideline PH24 (2010), recommendation 9

Common mental health problems: identification and pathways to care. NICE guideline CG123 (2011), recommendation 1.4.1.6

Specification

Numerator: The number of patients in the denominator who have been screened for hazardous drinking using the FAST or AUDIT-C tool in the 3 months before or after their diagnosis being recorded.

Denominator: The number of patients with a new diagnosis of depression or anxiety in the preceding 12 months.

Calculation: Numerator divided by the denominator, multiplied by 100.

Exclusions:

Minimum population: The indicator would be appropriate to assess performance at individual general practice level.

ISBN: 978-1-4731-5972-3