The Assessment of Alcohol‐Related Problems: a Need for a New Perspective

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Abstract
While general practice represents an appropriate point for detecting and intervening with those with alcohol‐related problems, existing data suggest that family physicians are currently unable to identify correctly those with such problems. Among the reasons which may explain these low detection rates is the absence of a suitable screening instrument for use in this setting. A set of criteria against which any instrument should be tested before being employed in the general practice setting is outlined. These criteria state that the scale should have three major characteristics. Firstly, it should be acceptable to patient and general practitioner. Secondly, the scale must have a conceptual frame which acknowledges the multidimensionality of problems; allows measurement of direct and indirect problems; is capable of detecting changes over time; focuses on non‐dependent rather than dependent problems; and which is based on experts' and consumers' agreement as to what constitutes a problem. Finally the scale should have demonstrated adequate reliability and validity within general practice. Existing scales fail to meet the majority of these criteria. As a consequence, the Primary Care Group at Newcastle is attempting to develop a scale which meets the specified criteria. Preliminary results indicate that the constructed scale does have some promise.