Recognition of Alcohol related brain damage on a Gastroenterology Unit

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Introduction

Alcohol Related Brain Damage (ARBD) is characterised by prolonged cognitive impairment with link to excessive alcohol ingestion and thiamine deficiency.

There is a current drive in Northern Ireland and elsewhere in the UK, to address the service needs for patients with ARBD.

Methods

A questionnaire was distributed among health care professionals in a regional Gastroenterology unit to assess the overall awareness of ARBD, recognition and subsequent treatment with view to service development.

Results

22 responses were collected (consultants, junior doctors and nurses) Each had variable exposure to ARBD patients on daily, weekly and monthly basis (n=2,11 & 9). 50% described problems with the detection and diagnosis of ARBD with delayed diagnosis in 32% and lack of special training 60%. Regular challenges included managing behavioural difficulties, aggression and concerns regarding patient and staff safety in non specialised wards. 50% felt facilities for current management of ARBD required improvement. (No official Protocol (50%) ,lack of specialised unit (40%), lack of support on discharge (27%) Suggestions for service development included a specialised unit,regional protocol for management, training to healthcare providers in dealing with ARBD patients,Increase psychiatric input and supportive rehabilitation facilities.

Conclusion

The study highlights the lack of services for ARBD patients in Northern Ireland leading to delayed diagnosis and initiation of appropriate treatment. Early intervention into acute wards will significantly improve the outcome for these patients, and improve patient and staff safety on the wards. Investment is required to provide education, develop ARBD care pathways and a specific rehabilitation Unit in Northern Ireland.