STREAM: Elucidating How Alcohol Use Disorders are Managed in UK General Practice Today.

AIMS: To characterize a contemporaneous cohort of UK general practice patients with alcohol use disorder and describe their management. METHODS: Prospective observational study in 25 primary care practices in England and Scotland. Adult patients with known or suspected alcohol dependence (Alcohol Use Disorders Identification Test score ≥8) were followed for 6 months and were profiled using baseline data. Changes over time in treatment for alcohol dependence (strategy, goals, modality) and the level of compliance were examined. RESULTS: Targeted case identification was a feasible means of identifying patients with DSM-IV confirmed alcohol dependence in general practice. In the cohort (n = 218), mean total alcohol consumption was high (men: 86.9 g/day; women: 62.7 g/day) and psychiatric co-morbidities were common (depression: 25.8% of patients; anxiety disorders: 25.8% of patients). At baseline, about half of patients reported ongoing or planned treatment for alcohol dependence. Over 6 months' observation, treatment modalities did not change and most patients retained their original stated treatment goal of abstinence or reduced alcohol intake. CONCLUSIONS: Targeted case identification in general practice identifies patients with alcohol use disorder in need of treatment.