Protocolo para el abordaje y derivación de los pacientes con problemas relacionados con el alcohol en el área de salud del Hospital Sierrallana / Protocol for the management and referring of the patients with alcohol related problems in Hospital Sierrallana area

Objetivo: El consumo de bebidas alcohólicas está asociado a una importante morbilidad y mortalidad. A pesar de que es un hecho aceptado entre los profesionales sanitarios, y de que la prevalencia en nuestro medio es alta (alrededor de un 7 % de la población general), no se corresponde con los casos detectados y tratados en nuestras consultas. Por este motivo se ha puesto en marcha un grupo de trabajo constituido por miembros del Programa de Alcohol de la Unidad de Salud Mental del Hospital Sierrallana y médicos de familia de la Gerencia de Atención Primaria Torrelavega-Reinosa. El objetivo primordial es fomentar la sensibilización de los profesionales acerca de los problemas generados por el consumo excesivo de alcohol. Material y métodos: Se ha elaborado un protocolo consensuado para el abordaje y derivación de los problemas relacionados con el alcohol desde Atención Primaria al Programa de Alcohol. Resultados: Para conseguirlo se han establecido unos criterios de derivación claros. Entendiendo que el abordaje debe ser multidisciplinar, se ha establecido una vía de comunicación directa entre Atención Primaria y especializada, permitiendo un tratamiento combinado entre ambas. El documento recoge la clasificación del tipo de bebedor según criterios cuantitativos, y diferencia la actitud diagnóstica y terapéutica en cada caso. Para el cribado entre abuso y dependencia se han usado las pruebas de AUDIT, CAGE y los criterios diagnósticos de las clasificaciones CIE y DSM. Finalmente, se ha creado un modelo de volante de interconsulta que pretende ser un instrumento concreto y eficaz para la comunicación entre Atención Primaria y el Programa de Alcohol. Conclusiones: La elaboración de un protocolo consensuado para el abordaje y derivación de los problemas relacionados con el alcohol desde Atención Primaria al Programa de Alcohol favorecerá una identificación y un abordaje terapéutico precoces (AU)

Objective: The alcohol consumption is associated with an important morbidity and mortality. Health professionals know about this risk and the high prevalence of alcoholism (about 7 % of the general population in our area). But in spite of this knowledge there is no correspondence between the cases detected and the cases treated in our daily practice. For this reason, we have created a group constituted by members of the Alcohol Program pertaining to the Sierrallana Hospital's Mental Health Unit and family doctors who work for the Torrelavega-Reinosa Primary Care Area. The main objective of this protocol is to raise the professionals' awareness about this topic. Material and methods: We have developed a protocol for the management and referring of the patients with alcohol abuse and its consequences from Primary Care to the Alcohol Program. Results: We have defined referral criteria to make this objective easier. We understand that the approach to this problem area must be multidisciplinary, so we have established a direct way of communication between Primary Care and Psychiatry that permits a coordinated treatment. The document classifies the kind of drinker according to quantitative criterias and differentiates the diagnose and the treatment for each case. For screening of abuse and alcohol dependence we have used the tests AUDIT, CAGE and the diagnostic criterias CIE and DSM-IV. Finally, we have made a model of an interclinical referral note that aims to be an efficient tool for the communication between Primary Care and the Alcohol Program. Conclusions: The development of a protocol for the management and referring of the patients with alcohol abuse and its consequences from Primary Care to the Alcohol Program will lead to a better identification of the patients and a treatment as precocious as possible (AU)

Alcohol consumption in a rural area of Cantabria.

A two-stage cross-sectional survey was performed in a representative rural sample of the autonomous community of Cantabria, to investigate the social, medical and psychopathological factors associated with alcohol consumption. Alcohol consumption was investigated by means of a specific questionnaire. Mental and physical health was evaluated in the first-stage sample using: (1) the General Health Questionnaire, (2) the Cornell Medical Index. In the second stage all members of the sample were interviewed at home using the 140-item version of the Present State Examination (PSE-9). We found that 25.4% of males and 0.6% of females were consuming more than 63 alcohol units per week. Alcohol consumption was significantly associated with different social variables. Although it was possible to detect an increase in weekend drinking, especially in the heavy alcohol users, daily alcohol consumption, mainly around meals, was the predominant drinking pattern. We also found a significant inverse association between excessive alcohol consumption and the presence of physical or mental illness. Excessive alcohol use tended to be associated in males with depression and in females, with anxiety.

[Alcohol-related problems in Cantabria]. / Problemas relacionados con el alcohol en Cantabria.

It is a cross sectorial epidemiological community survey into a random sample of 1,816 adult people. The objetivo of our work is to test the existence of some social-demographic variables that can be accumulated to the existence of alcohol related problems. We found that the men, the young people, with low socioeconomic level, and semiurban style of life have the highest risk of alcohol related problems. 48% of the sample men have recognized any alcohol related problems during the previous year to our study. The highest problem prevalence is associated to increased alcohol consumption. After all, there are many people with low alcohol consumption who have alcohol related problems.

[Bibliographic analysis of the concept "alcohol-related problems"]. / Análisis bibliográfico del concepto "problemas relacionados con el alcohol".

This survey, which is related to one of the research lines of our Unit, has a main objective to conduct a bibliographic analysis, in the medical literature of the "Alcohol Related Problems", (A.R.P.) concept. For this reviewed, by means of the MEDLINE data base, the last five years of the international scientific literature, selecting as key words: "Alcohol Related Problems", "Epidemiology", "Alcohol Drinking", "Social Problems". We detected 215 publications with abstracts, 174 presented data from epidemiological surveys and the remaining 31 were related to theoretical aspect. In 90 per cent of the revised articles alcohol was considered a risk factor and cause of illness; however, only 13 percent of them used the A.R.P. terminology. The majority of these studies were related to epidemiological surveys, mainly of a descriptive nature and with a cross-sectional or a retrospective design. We also identified, among other things, an increasing interest for the medical and social aspects of the A.R.P., this appears to be related to a more innovative view of this health problems.

[Social and family variables related to alcohol consumption]. / Variables sociofamiliares relacionadas con el consumo de alcohol.

The present study analyzed some family factors which are considered to be relevant for excessive alcohol consumption. Such analysis is conducted on the data derived from a cross-sectional epidemiological community survey directed to investigate, in a random sample of 1.800 persons of 18 to 65 years of age--and representative of the population of Cantabria--community responses to alcohol consumption. For this we applied among other instruments, a questionnaire designed by the WHO for exploring Alcohol consumption, and which has being extensively used in other countries. We found, among other things, that: i) Among the males excessive alcohol consumption tends to be higher in the single marital status, and also in those with a higher number of brothers; ii) On the females on the contrary, single marital status is associates to higher percentages of non excessive alcohol consumption, while the fact of having a higher number of brothers is related to higher rates of non consumption of alcohol.

[Family response and alcohol consumption]. / Respuesta familiar y consumo de alcohol.

The present study has its main objective the analysis of family responses to excessive alcohol consumption. For this we used data derived from a cross-sectional epidemiological community survey directed to investigate, in a random sample of 1.800 persons of 18 to 65 years of age and representative of the population of Cantabria community responses to alcohol consumption. We applied, among other instruments, a questionnaire designed by the WHO for exploring alcohol consumption, and which has being extensively used in other settings. We found, among other things, that: i) The concern about parents excessive alcohol consumption has different repercussions depending of the sex of their children, thus producing more alcohol related problems in males; ii) The concern for the alcohol consumption of ones partner is more often seeing in females, thus females tend to be more sensitive to these problems, and also they tend to detect them earlier and be more tolerant to them; iii) Persons who worry for the alcohol consumption of their partners usually have also had parents with such sort of problems; iv) And lastly about 11% of males and 13% of females with adolescent children tend to worry about the children' excessive alcohol consumption.

[Prevalence and psychosocial patterns of alcohol consumption in Cantabria]. / Prevalencia y patrones psicosociales de consumo de alcohol en Cantabria.

This is a cross-sectional community survey directed to investigate aspects related ot the alcohol consumption of 1,816 persons, of 16-65 years of age, representative of the population of Cantabria. It was found, among other things, that 7% of the male and 23% of the female were abstinent, being the prevalence for excessive alcohol consumption of 14.36% for males and of 0.22% for females. We also found, especially among the younger age groups, a growing female incorporation into the masculine patterns of alcohol consumption. It was also analyzed in the study the characteristics of the patterns of alcohol consumption. We found, in this respect, for the different socio-demographic groups of this community, specific profiles of alcohol consumption.