An adapted alcohol screening test will help to fight health harms in the Russian Federation and beyond

WHO/Europe has presented a new package of Russian- and English-language materials to help primary health-care workers in many countries of the eastern part of the WHO European Region to identify patients with risky drinking behaviours. The materials will allow health professionals to support people who might experience harm from drinking or be at risk without even knowing it.

Globally, the Region has the highest level of alcohol consumption, with associated deaths reaching almost 1 million each year. This is around 2500 deaths every day. Alcohol is the leading risk factor for many noncommunicable diseases (NCDs), such as cardiovascular and digestive diseases and cancers, as well as injuries.

Primary health care can help to reduce alcohol-related risks

Any amount of consumed alcohol can harm the body, and so dealing with these risks and offering support to patients is not only the role of addiction specialists. Health systems and health professionals at every level, but especially in primary care, should be empowered to address these risks by increasing patients’ health literacy and providing the necessary tools to meet their needs.

Quick and effective alcohol screening tests and brief interventions, such as short motivational counselling sessions, can help patients at risk to reduce their drinking levels and avoid serious longer-term health harms stemming from alcohol.

Moreover, early interventions in primary health care require fewer resources and are more cost-effective than the specialized treatment of already-manifested alcohol use disorders.

The Russian AUDIT: identifying alcohol use disorders at early stages

To help identify people at risk and offer brief interventions in health-care settings, WHO developed the Alcohol Use Disorders Identification Test (AUDIT). This simple screening test consisting of 10 questions allows general practitioners to identify people with harmful and hazardous alcohol consumption patterns before health and social consequences are pronounced and require urgent help.

AUDIT is one of the most frequently used screening instruments for alcohol use worldwide. But up to now, the Russian version of the tool has not been validated. A new WHO/Europe report presents the work on RUS-AUDIT, the Russian-language AUDIT test that is specially tailored for use in primary health-care facilities of the Russian Federation.

In addition to the test and the report, WHO/Europe presented the protocol and training materials that will allow RUS-AUDIT to become an integral part of the health system.

Tailored for eastern European countries

“The exchange of experience and collaboration with experts in the Russian Federation were critical elements of this work,” explained Dr Melita Vujnovic, WHO Representative to the Russian Federation. “This collaboration has gone on for several years now, and Russian primary health-care professionals in different parts of the country have been testing and implementing the WHO-recommended screening and brief intervention measures and providing valuable inputs to WHO. WHO and the Ministry of Health of the Russian Federation continue to collaborate, contributing to the knowledge and experience base.”

Dr Vujnovic added, “We are looking forward to wider implementation of this important tool, which will help us all to get closer to achieving the global, regional and national targets for the prevention and control of harmful alcohol use, as one of the best buys to fight NCDs.”

RUS-AUDIT can help the Russian Federation and potentially other Member States to implement effective screening and brief intervention systems that can enhance other alcohol-control policies. It takes into account translation issues; the interpretation of questions by a Russian target audience, including the WHO concept of a standard drink; and the specific drinking patterns observed in the Russian Federation and other countries of the eastern part of the Region.

“To be effective, screening and brief interventions require reliable and easy-to-use instruments in the context of limited time spent in primary health care. RUS-AUDIT gives health professionals an opportunity to educate patients about the risks of excessive alcohol use, increase their health literacy and offer support to reduce drinking prior to the development of alcohol abuse,” said Dr Lyubov Drozdova, Chief Specialist of Preventive Medicine at the National Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation.

Long-lasting protection from alcohol harms

“In some countries of the WHO European Region, patients with alcohol use disorders can get medical help only if their health condition deteriorates to a critical level with strong manifestation of clinical symptoms,” pointed out Dr Carina Ferreira-Borges, ad interim Head of WHO European Office for the Prevention and Control of Noncommunicable Diseases. “Implementing screening and brief interventions and ensuring a continuum of care between primary and specialized health care are essential and lie at the very heart of the WHO European Programme of Work.”

The European Programme of Work 2020–2025 reflects WHO/Europe’s determination to leave no one behind and to strengthen the leadership of health authorities in the Region.