The way alcohol services are currently provided in Ireland is disjointed, and experts believe that a more collaborative approach, such as a multidisciplinary team (MDT) approach, could lead to better outcomes.
Almost 200 individuals participated in a recent virtual meeting focused on addressing the alcohol crisis in Ireland. The event was organized by Prof John Ryan, a Consultant Hepatologist at Beaumont Hospital, Dublin, and an Associate Professor at the Royal College of Surgeons in Ireland (RCSI).
Joining Prof Ryan were his colleagues Prof Siobhan MacHale, a Consultant Psychiatrist at Beaumont Hospital, and Dr Hugh Gallagher, the GP Co-ordinator in the Health Service Executive (HSE) Addiction Service in Dublin North City & County.
Prof Ryan highlighted the fragmented nature of current alcohol services in Ireland and emphasized the potential benefits of a more coordinated approach.
Ireland ranks fifth in Europe for alcohol-related harm1, imposing a significant burden on the healthcare system1. Data from Beaumont Hospital alone reveals that a substantial percentage of Emergency Department visits and Intensive Care Unit admissions are alcohol-related.
During the same period, alcohol-related inpatient admissions resulted in over 9,600 bed days at a minimum cost of €8,146,752. Neurosurgery admissions related to alcohol incurred a cost exceeding €834,000.
Prof Ryan discussed the escalating rates of liver disease in Ireland across all age groups, emphasizing the urgent need for a comprehensive approach to address this public health issue.
Ireland has the fifth highest rate of alcohol-related harm in Europe, posing a significant burden on the healthcare system.
The COVID-19 pandemic has further exacerbated the issue, with a noticeable increase in online alcohol purchases. This trend is expected to strain healthcare resources even further.
Prof Ryan proposed the establishment of Alcohol Care Teams (ACTs) as a potential solution to alleviate the burden on the healthcare system in Ireland. These teams would be consultant-led, multidisciplinary, and patient-centered, operating seamlessly between primary and secondary care settings.
He outlined a model for an Acute Hospital Alcohol Care Team, which includes a seven-day alcohol specialist nurse service and coordinated policies for emergency departments and acute medical units.
Prof Ryan drew from his experience in developing an Alcohol Care Team in a UK hospital, emphasizing the need for similar teams across Ireland to foster a collaborative approach and improve patient outcomes.
Prof MacHale, drawing on her extensive experience in Liaison Psychiatry, emphasized the importance of early detection and intervention for alcohol-related issues in hospital settings. She stressed the need for timely diagnosis to improve patient outcomes and reduce healthcare costs.
Prof MacHale also highlighted the role of Alcohol Care Teams in providing screening, brief interventions, safe detoxification, and linkages to community support services, emphasizing the potential benefits of early identification and treatment.
Dr Gallagher emphasized the importance of a team-based approach in both primary and secondary care settings to address alcohol dependence effectively. He highlighted the challenges faced in primary care and underscored the opportunities for screening and intervention in routine patient interactions.
Screening for alcohol misuse can be integrated into various primary care interactions, offering a proactive approach to identifying at-risk individuals and providing appropriate interventions.
Dr Gallagher reiterated the importance of patient engagement and early intervention in addressing alcohol-related issues, emphasizing the role of healthcare providers in offering support and holistic care to individuals with alcohol dependence.
Prof Ryan concluded the meeting by calling for the establishment of Alcohol Care Teams in every hospital in Ireland, emphasizing the need for a collaborative, multidisciplinary approach to tackle the alcohol crisis effectively.
For those interested in contributing to the development of alcohol services in Ireland, Prof Ryan can be contacted at: alcoholservice@beaumont.ie.
The educational meeting referenced in this report was sponsored by Kyowa Kirin Ltd to support medical education. Kyowa Kirin had no influence on the content of the presentations, ensuring compliance with pharmaceutical industry regulations.
KKI/IRE/NPR/0003. Date of Preparation January 2021.
References
- Mongan D & Long J, HRB 2016 alcoholireland.ie.
- Hacioglu S et al CEPR 2020
- Williams R et al., The Lancet Liver Commission 2014; NICE 2011/2016; https://fg.bmj.com/content/flgastro/early/2019/08/14/flgastro-2019-101241.full.pdf.
- Cancer Research UK 2018.
- Crawford MJ. et al, The Lancet 2004.
- Ryder S et al., Clin Med 2010; Liverpool Public Health Observatory 2010.
- Hughes NR et al. Front Gastro 2013; NCEPOD report 2013; Williams R et al., The Lancet Liver Commission 2014; Ryder S et al., Clin Med 2010; PHE 2014.
- www2.hse.ie/wellbeing/alcohol/improve-your-health/weekly-low-risk-alcohol-guidelines.html.
- Bush K, Kivlahan DR, McDonell MB, et al. The AUIDIT Alcohol Consumption Questions (AUDIT-C). Arch Intern Med. 1998 Sep 14;158(16):1789-95.