Alcohol and drug research

This research will explore how the short alcohol screening tests can be used in the emergency departments (ED) to accurately identify those in need of treatment. An additional study will utilise qualitative methodologies among clinical staff to identify strategies for the implementation of short alcohol screening tools within local emergency departments and identify care pathways for ED attenders experiencing alcohol dependence.  

All adult (≥ 18years) ED attenders clinically cleared by ED Staff will be approached to participate in the study by trained researchers over each 24-hour period for two weeks.

Participants will be asked to complete the following questionnaires:

• We will ask for information related to method and reason for attendance, demographic information (e.g. age, gender, etc.), and information on their use of hospital and social services over the last 12 months
• We will ask questions to identify alcohol use disorders (AUD) (i.e. harmful drinking and alcohol dependence) using the validated the 10-item Alcohol Use Disorders Identification Test (AUDIT-C) and 4-item FAST questionnaires
• Those who report consuming alcohol will be asked to complete the 8-item Home Drinking Assessment Scale (HDAS)

Those presenting following violent incidents/assaults will be asked about the place, time of the incident and nature/severity of injuries.

Consent to access their ED patient record for their related attendance will be requested in order to obtain the ED clinician’s diagnosis and discharge code. Statistical analysis will assess the accuracy of the FAST and AUDIT-C in identifying AUD amongst adult emergency department attendees. Those ED attendees with an AUD and presenting following violent incidents/assaults will be characterised. Those identified as being alcohol dependent will be advised to access their local specialist service. All participants will receive a voucher thanking them for their participation in the study.

The qualitative study will recruit clinical staff from four clinical settings based within local acute hospitals and specialist alcohol services to examine the clinical barriers and facilitating factors of access to treatment for alcohol dependent ED attenders.

AIMS

The results of the study will inform the development of care pathways for people who experience alcohol dependence across Hull, East Riding, and North East and North Lincolnshire who are admitted to hospital or require direct access to specialist community treatment. Data relating to violent incidents and assaults will inform policing and licensing strategies in the locality.

FUNDED BY

The project is funded by The Office of the Police and Crime Commissioner, National Institute for Health Research Clinical Research Network (NIHR CRN) for Yorkshire and The Humber and sponsored by Hull University Teaching Hospitals NHS Trust.

UNIVERSITY OF HULL

Professor Thomas Phillips, Professor of Nursing (Addictions), Faculty of Health Sciences

Professor Colin Martin, Professor of Perinatal Mental Health, Faculty of Health Sciences

Dr Judith Cohen, Director, Hull Health Trials Unit

Dr Maureen Twiddy, Senior Lecturer in Mixed Methods Research 

Professor Iain Brennan, Professor in Criminology, Faculty of Arts, Cultures and Education

Bronwen Williams, Trial Manager, Hull Health Trials Unit

UNIVERSITY OF KENT

Professor Simon Coulton, Professor of Health Service Research, Centre for Health Service Research

KING’S COLLEGE LONDON

Professor Colin Drummond, Professor of Addiction Psychiatry

HULL UNIVERSITY TEACHING HOSPITALS NHS TRUST  

Dr Fraser Young, Consultant in Emergency Medicine

NORTHERN LINCOLNSHIRE AND GOOLE NHS FOUNDATION TRUST 

CONTACT

Chief Investigator: Professor Thomas Phillips, ICAHR, University of Hull
FASTer@hull.ac.uk

Public health messages have focussed on the avoidance and reduction of alcohol use as well as supporting changes in healthcare services to reduce community transmission of COVID-19. This study led by Prof Thomas Phillips, the University of Hull in collaboration with King’s College London and the University of Kent will examine the impact of these measures on adult harmful and dependent drinkers living in the UK, including the impact on treatment provision and help-seeking opportunities.

All adults (≥18years) who have consumed alcohol in the last 12 months and living in the UK and who experience harmful drinking or alcohol dependence will be eligible to participate in a confidential online survey. Eligible participants will be asked to complete information related to; i) demographics, ii) use of alcohol and help-seeking before the lockdown iii) motivation to change drinking and quit attempts since the lockdown (including their experience of specialist service, if applicable), iv) the impact of restrictions on finances, alcohol, smoking, vaping, cannabis use, medications, and exercise and, v) COVID-19 symptoms. Those participating will be entered into a prize draw for three computer tablets (iPads). The primary aim will explore changes in alcohol consumption among those with harmful drinking or alcohol dependence since the implementation of social restrictions. A detailed exploratory analysis will be undertaken and where possible weighted using weights from the Adult Psychiatric Morbidity Survey and National Drug Treatment Monitoring System (NDTMS).

Aims

Harmful and alcohol-dependent drinkers are a vulnerable group at risk of severe manifestations of COVID-19. This study will help to assess the impact of social restrictions on this group and inform future policy responses.

Funded by

University of Hull

King’s College London

University of Kent

University of Hull

Professor Thomas Phillips Professor of Nursing (Addictions), Faculty of Health Sciences

Dr Judith Cohen, Director, Hull Health Trials Unit

John Turgoose, Hull Health Trials Unit

Sarah Sumpter, Hull Health Trials Unit

University of Kent

Professor Simon Coulton, Professor of Health Service Research, Centre for Health Service Research

King’s College London

Professor Colin Drummond, Professor of Addiction Psychiatry

Dr Paolo Deluca, Reader in Addiction

Dr Andreas Kimergard, Research Fellow

Contact

Chief Investigator: Professor Tom Philips, ICAHR, University of Hull

SACCOStudy@hull.ac.uk

Recent research conducted outside the UK has identified hospital readmission rates following alcohol withdrawal are linked to discharges against medical advice and the complexity of the patients. Furthermore, incomplete programmes of care during hospital care may influence a premature return to excessive drinking on discharge and subsequent readmission. This study aims to examine routine hospital data to examine characteristics and predictors of alcohol withdrawal readmissions and emergency department attendances in England by linking Hospital Episode Statistics (HES) Admitted Patient Care data sets with HES Accident & Emergency data sets for 2017/18 (NHS Data Access Request Service (DARS) Reference: DARS-NIC-226185-B6C2J)

AIMS

The results will provide valuable evidence to inform the development of Alcohol Care Teams prioritised under the NHS Long-Term Plan. The findings will also inform the development of future research to address readmission rates in patients experiencing alcohol dependence and alcohol withdrawal.

Funded by

University of Hull

Related research

Phillips, T., Coulton, S., & Drummond, C. (2019). Burden of alcohol disorders on emergency department attendances and hospital admissions in England. Alcohol and Alcoholism

Prof Thomas Phillips, Principal Investigator & Professor of Nursing (Addictions), Faculty of Health Sciences, University of Hull.

Dr Ireneous Soyiri, Senior Lecturer (Epidemiology), Faculty of Health Sciences/Hull York Medical School, University of Hull

Prof Simon Coulton, Professor of Health Service Research, Centre for Health Service Research, University of Kent

CONTACT

Prof Thomas Phillips, 01482 464396, Thomas.Phillips@hull.ac.uk

Institute for Clinical and Applied Health Research, together with the University of Southampton and the Royal College of Psychiatrists are supporting NHS England & Improvement and Public Health England to develop clinical competence profiles for secondary care alcohol specialist roles. This work is seen as a vital step in developing efficient learning and development resources to train the additional staff required for the widespread service improvement of ACTs recommended in the NHS Long Term plan.

AIMS

We have recruited an expert panel of clinicians to participate in a Delphi study to develop interdisciplinary consensus on the competencies that alcohol care teams require to identify, assess, engage and manage patients who experience alcohol-related hospital admissions and ED attendances.

FUNDED BY

This project is funded by NHS England & Improvement and supported by Public Health England and Royal College of Psychiatrists

OUTPUTS

Thomas Phillips, Amy Porter, Julia Sinclair, Clinical Competencies for the Care of Hospitalized Patients with Alcohol Use Disorders, Alcohol and Alcoholism, Volume 55, Issue 4, July 2020, Pages 395–400.

UNIVERSITY OF HULL

Professor Thomas Phillips, Project Lead, Professor of Nursing (Addictions) and Co-opted Member of the Faculty of Addictions, Royal College of Psychiatrists

Amy Porter, Project Co-ordinator, Hull Health Trials Unit

UNIVERSITY OF SOUTHAMPTON

Professor Julia Sinclair, Project Director and Professor of Addiction Psychiatry, Faculty of Medicine and Chair: Faculty of Addictions, Royal College of Psychiatrists

CONTACT

Professor Thomas Phillips,
01482 464396, Thomas.Phillips@hull.ac.uk

Communities in the local area specifically face greater prevalence of alcohol disorders, and increasing alcohol-related admissions, alcoholic liver disease, alcohol-related cardiovascular disease and related mortality. Interventions designed to reduce alcohol-related harm have largely focussed on brief interventions and psychosocial treatments; however, the impact of brief interventions is limited, and four out of five people in need fail to access treatment. There is, therefore, a need to develop interventions with greater efficacy, uptake and long-term benefits.

Based in the Institute for Clinical and Applied Health Research (ICAHR) this programme of research comprises of three PhD studentships awarded to Lady Gwendoline Akwa, Buse Apel and Saphsa Codling who will develop an understanding of the relationships between excessive alcohol consumption and physical activity in reducing harms.

FUNDED BY

Alumni Office, University of Hull

PHD SCHOLARSHIPS

Lady Gwendoline Akwa
Development of a lifestyle physical activity intervention for women who misuse alcohol
Prof Lesley Smith, Dr Grant Abt, Dr Maureen Twiddy

Buse Apel
Exploring the Role of Physical Activity in the Treatment of Alcohol Dependence
Prof Thomas Phillips, Dr Judith Cohen, and Dr Grant Abt

Saphsa Codling
Alcohol and Physical Activity PhD Scholarship: Elucidating the relationships between physical activity and risk of alcohol-related harm/consumption using social determinants of health in early to mid-adolescence
Prof Lesley Smith, Prof Thomas Phillips and Prof Colin Martin 

SUPERVISORS

Professor Thomas Phillips, Research Cluster Lead, Professor of Nursing (Addictions), Faculty of Health Sciences

Professor Lesley Smith, Professor of Women's Public Health 

Professor Colin Martin, Professor of Perinatal Mental Health, Faculty of Health Sciences

Dr Judith Cohen, Director, Hull Health Trials Unit

Dr Grant Abt, Reader (Associate Professor) in Sport and Exercise Physiology

Dr Maureen Twiddy, Senior Lecturer in Mixed Methods Research 

CONTACT

Professor Thomas Phillips, Research Cluster Lead
01482 464396, Thomas.Phillips@hull.ac.uk

Nonattendance at addiction prescriber consultation appointments is high and worsens patient’s outcomes. Telemedicine has been shown to improve attendance for some medical specialities and may be an intervention that could improve attendance rates in addictions.

AIMS 

Telemedicine consultations will be compared to standard face-to-face consultations to assess clinical attendances with an addiction prescriber. Secondary outcomes assess patient and staff satisfaction with telemedicine consultations, travel distances and transport costs.

FUNDED BY

This study is funded by Academic Health Science Network for Yorkshire and Humber and the East Riding Clinical Commissioning Group (CCG). Humber Teaching NHS Foundation Trust sponsor this project.

HUMBER TEACHING NHS FOUNDATION TRUST 

Dr Soraya Mayet (PI) Consultant Psychiatrist - Humber Teaching NHS Foundation Trust & Honorary Senior Clinical Lecturer - Hull and York Medical School

Dr Iain McCaw, Higher Trainee Psychiatry - Humber Teaching NHS Foundation Trust & Research coordinator 

UNIVERSITY OF HULL

Professor Thomas Phillips, Professor of Nursing (Addictions), Faculty of Health Sciences

Dr Chao Huang, Senior Lecturer in Statistics, Faculty of Health Sciences

John Turgoose, Hull Health Trials Unit

RESEARCHERS

Ms Emma Welsh, Hull and York Medical School

Dr Zeeshan Hashmani, Humber Teaching NHS Foundation Trust

Dr Zuzana Drozdova, Humber Teaching NHS Foundation Trust 

CONTACT

Dr Soraya Mayet (PI) Consultant Psychiatrist - Humber Teaching NHS Foundation Trust & Honorary Senior Clinical Lecturer - Hull and York Medical School smayet@nhs.net

Professor Thomas Phillips, University of Hull 01482 464396, Thomas.Phillips@hull.ac.uk

Lady Gwendoline Akwa

Alcohol and Physical Activity PhD Scholarship: Development of a lifestyle physical activity intervention for women who misuse alcohol

Supervisors: Prof Lesley Smith, Dr Grant Abt, Dr Maureen Twiddy

Commenced: Sept 2019

Buse Apel

Alcohol and Physical Activity PhD Scholarship: Exploring the Role of Physical Activity in the Treatment of Alcohol Dependence

Supervisors: Prof Thomas Phillips, Dr Judith Cohen, and Dr Grant Abt

Commenced: Sept 2019

Saphsa Codling

Alcohol and Physical Activity PhD Scholarship: Elucidating the relationships between physical activity and risk of alcohol-related harm/consumption using social determinants of health in early to mid-adolescence

Supervisors: Prof Lesley Smith, Prof Thomas Phillips and Prof Colin Martin

Commenced: Sept 2019

Rachel Coleman

Study for the Society of Addiction (SSA) PhD Scholarship: Exploring the measurement and management of alcohol withdrawal in the acute general hospital setting

Supervisors: Prof Thomas Phillips and Prof Simon Coulton, University of Kent

Commenced: Sept 2020 

Usa Junyaem

Alcohol consumption and drinking behaviour among nursing students.

Supervisors: Prof Thomas Phillips and Dr David Barrett

Commenced: May 2020

Emma Robinson

Research: What helps and hinders access to alcohol treatment? Perspectives from people experiencing homelessness and alcohol dependence and homeless outreach and key workers. Clinical Psychology Doctorate (ClinPsyD)

Supervisors: Dr Nick Hutchinson and Prof Thomas Phillips

Nurun Tania

Hull University Teaching Hospitals NHS Trust & University of Hull Doctoral Scholarship: An examination of current pathways for patients receiving unplanned care for alcohol related liver disease (ARLD): A mixed methods approach to identify targets for improvement.

Supervisors: Prof Thomas Phillips, ICAHR, Dr Maureen Twiddy, HHTU, and Dr Lynsey Corless, HUTH

Commenced: Jan 2020 (Part-Time)

Roksana Malkowska-Michalak

Better Policing, Safer Communities PhD Scholarship: Understanding the multi-agency sharing of information about violence

Supervisors: Prof Iain Brennan, FACE & Prof Thomas Phillips, ICAHR

Commenced: Sept 2020

Donoghue, K., Rose, A., Coulton, S., Coleman, R., Milward, J., Phillips, T., Drummond, C. and Little, H., (2020) Double-blind, placebo-controlled trial of mifepristone on cognition and depression in alcohol dependence. Trials (Accepted 5^th September)

Phillips, T., Huang, C., Roberts, E. & Drummond, C. (2020) Specialist Alcohol Inpatient Treatment Admissions and Non-Specialist Hospital Admissions for Alcohol Withdrawal in England: an inverse relationship. Alcohol and Alcoholism. 10.1093/alcalc/agaa086

Phillips, T., Porter, A., & Sinclair, J. (2020) Clinical competencies for the care of hospitalised patients with alcohol use disorders. Alcohol and Alcoholism, 55(4); 395-400.

Deluca, P., Coulton, S., Alam, M. F., Boniface, S., Donoghue, K., Gilvarry, E., Kaner, E., Lynch, E., Maconochie, I., McArdle, P., McGovern, R., Newbury-Birch, D., Patton, P., Pellatt-Higgins, T., Phillips, C., Phillips, T., Pockett, R., Russell, I.T., Strang, J. and Drummond., C. (2020) Screening and brief interventions for adolescent alcohol use disorders presenting through emergency departments: a research programme including two RCTs. Programme Grants Appl Res; 8(2).

Phillips, T., Coulton, S., & Drummond, C. (2019). Burden of alcohol disorders on emergency department attendances and hospital admissions in England. Alcohol and Alcoholism, 54(5); 516-524

B Katikireddi, S. V., Beeston, C., Millard, A., Forsyth, R., Deluca, P., Drummond, C., Eadie, D., Graham, L., Hilton, S., Ludbrook, A., McCartney, G., Phillips, T., Stead, M., Ford, A., Bond, L. and Leyland, A.H. (2019) Evaluating possible intended and unintended consequences of the implementation of alcohol minimum unit pricing (MUP) in Scotland: a natural experiment protocol. BMJ Open;9:e028482.

Brennan A, Hill-McManus D, Stone T, Buykx P, Ally A, Pryce RE, Alston R, Jones A, Cairns D, Millar T, Donmall M, Phillips T, Meier P, and Drummond C. (2019) Modeling the Potential Impact of Changing Access Rates to Specialist Treatment for Alcohol Dependence for Local Authorities in England: The Specialist Treatment for Alcohol Model (STreAM). Stud Alcohol Drugs Suppl. Jan;Sup 18:96-109.

Coulton S. Dale V. Deluca P. Gilvarry E. Godfrey C. Kaner E. McGovern R. Newbury-Birch D. Patton R. Parrott S. Perryman K. Phillips T. Shepherd J. Drummond C. Heather N. (2018). Corrigendum: Screening for at-risk alcohol consumption in primary care: A randomized evaluation of screening approaches. Alcohol and Alcoholism. [Epub ahead of print].

Coulton S. Alam M.F. Boniface S. Deluca P. Donoghue K. Gilvarry E. Kaner E. Lynch E. Maconochie I. McArdle P. McGovern R. Newbury-Birch D. Patton R. Phillips C.J. Phillips T. Rose H. Russell I. Strang J. Drummond C. (2018). Opportunistic screening for alcohol use problems in adolescents attending emergency departments: an evaluation of screening tools. Journal of Public Health. [Epub ahead of print]. 

Coulton, S., Dale, V., Deluca, P., Gilvarry, E., Godfrey, C., Kaner, E., McGovern, R., Newbury-Birch, D., Patton, R., Parrott, S., Perryman, K., Phillips, T., Shepherd, J., and Drummond, C.D. (2017) Screening for At-Risk Alcohol Consumption in Primary Care: A Randomized Evaluation of Screening Approaches. Alcohol and Alcoholism 52 (3): 312-317.

Donoghue, K., Rose, H., Boniface, S., Deluca, P., Coulton, S., Alam, M.F., Gilvarry, E., Kaner, E., Lynch, E., Maconochie, I., McArdle, P., McGovern, R., Newbury-Birch, D., Patton, P., Phillips, C.J., Phillips, T., Russell, I., Strang, J. and Drummond, C. (2017) Alcohol Consumption, Early-Onset Drinking, and Health-Related Consequences in Adolescents Presenting at Emergency Departments in England. Journal of Adolescent Health 60 (4): 438–446

Brennan, A., Buykx, P., Pryce, Jones, A., Hill-McManus, D., Stone, T., Ally, A., Gillespie, D., Meier, P., Alston, R., Cairns, D., Millar, T., Donmall, M., Wolstenholme, A., Phillips, T., Elzerbi, C. and Drummond, C. D. (October 2016) An Evidence-Based Model for Estimating Requirements for Specialist Alcohol Treatment Capacity in England - The Specialist Treatment for Alcohol Model (STreAM) Version 1.0. Final report to Department of Health Policy Research Programme PR-R4-0512-12002. 

Phillips, T.S. (2016) What is the burden of alcohol related problems on Accident and Emergency Departments in England: An epidemiological analysis of the prevalence of alcohol use disorders (AUDs) within the AED setting. PhD thesis. King’s College, London

Phillips, T.S., Coulton, S. and Drummond, C. D. (2016) Using Hospital Episode Statistics to identify the burden of alcohol related conditions on Emergency Departments in England. Alcoholism: Clinical and Experimental Research. 40 (S1), 47A

Buykx, P., Alston, R., Stone, T., Jones, A., Drummond, C., Millar, T., Cairns, D., Donmall, M., Phillips, T., McManus, D., Brennan, A. (2015) Using routine administrative data from specialist alcohol treatment services in England to estimate client severity of dependence, complex needs and treatment pathways 41st Annual Alcohol Epidemiology Symposium of the Kettil Bruun Society (KBS) in Munich, June 1-5, 2015

Deluca, P., Coulton, S., Alam, M.F., Cohen, D., Donoghue, K., Gilvarry, E., Kaner, E., Maconochie, I., McArdle, P., McGovern, R., Newbury-Birch, D., Patton, R., Phillips, C., Phillips, T., Russell, I., Strang, J. & Drummond, C. (2015) Linked randomised controlled trials of face-to-face and electronic brief intervention methods to prevent alcohol related harm in young people aged 14-17 years presenting to Emergency Departments (SIPS junior). BMC Public Health 15:345

Newbury-Birch D, Coulton S, Bland M, Cassidy P, Dale V, Deluca P, Gilvarry E, Godfrey C, Heather N, Kaner E, McGovern R, Myles J, Oyefeso A, Parrott S, Patton R, Perryman K, Phillips T, Shepherd J, Drummond C. (2014) Alcohol Screening and Brief Interventions for Offenders in the Probation Setting (SIPS Trial): a Pragmatic Multicentre Cluster Randomized Controlled Trial. Alcohol and Alcoholism Jul 26. pii: agu046

Drummond, C., Deluca, P., Coulton, S., Bland, M., Cassidy, P., Crawford, M., Dale, V., Gilvarry, E., Godfrey, C., Heather, N., McGovern, R., Myles, J., Newbury-Birch, D., Oyefeso, A., Parrott, S., Patton, R., Perryman, K., Phillips, T., Shepherd, J., and Kaner, E. (2014) The Effectiveness of Alcohol Screening and Brief Intervention in Emergency Departments: A Multicentre Pragmatic Cluster Randomized Controlled Trial. PLoS ONE 9(6): e99463. 

Donoghue K, Patton R, Phillips T, Deluca P, Drummond C. (2014) The Effectiveness of Electronic Screening and Brief Intervention for Reducing Levels of Alcohol Consumption: A Systematic Review and Meta-Analysis. Journal of Medical Internet Research 16(5): e142