- Dr Elizabeth M. Proude, Drug Health Services, Royal Prince Alfred Hospital, Sydney South West Area Health Service and University of Sydney
- Associate Professor Katherine M. Conigrave, Drug Health Services, Royal Prince Alfred Hospital, Sydney South West Area Health Service and University of Sydney
- Dr Annette Britton, Royal Prince Alfred Hospital, Sydney South West Area Health Service
- Professor Paul S. Haber, Drug Health Services, Royal Prince Alfred Hospital, Sydney South West Area Health Service and University of Sydney
In 2000, the World Health Organization reported that alcohol was second only to tobacco and high blood pressure in the global disease burden. Yet an in-hospital audit of patients in 2001 revealed poor alcohol assessment and detection of related disorders by Junior Medical Officers (JMOs).
This project aims to determine the effectiveness of Individual Feedback and Group Feedback in improving JMOs recording, assessment and management of risky alcohol use and tobacco smoking. It uses a crossover trial conducted at two hospitals over two years.
Medical records of patients who had been admitted by JMOs were examined for records of alcohol use, quantified alcohol consumption, alcohol intervention, alcohol withdrawal, or a consultation from the Drug and Alcohol team. Data were also collected on tobacco use and nicotine replacement therapy.
In Year One the first hospital’s JMOs received printed Individual Feedback on their own and their groups results, while the second hospital’s JMOs received Group Feedback in the form of face-to-face presentations of their group’s results by one of the Staff Specialists. In Year Two the process was reversed.
A total of 3,025 patient records were examined by 130 JMOs and it was found that, after Individual Feedback, the percentage of records with any alcohol history remained static at 60%; however, the percentage of quantified histories rose from 69% to 92%. After Group Feedback, recording rates of alcohol and tobacco use remained static.
As a result, the study concluded that JMOs were significantly more likely to record alcohol status if the doctor was a first year intern, located at the second hospital, or if the patient was male and less than 70 years of age.
It was found that Individual Feedback on performance, with education about desired standards, is effective in improving the quality of recording of alcohol histories by Junior Medical Officers.
Proude, EM, Conigrave, KM, Britton, A & Haber, PS 200. Improving alcohol and tobacco history taking by junior medical officers. Alcohol and Alcoholism 2008 43(3):320-325.