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hello guys.
I had question.
If a patient just drinks occasional beers over the weekend -1-2 beers and has no hx of liver disease etc ,Do we still order " STOP ALCOHOL/ABSTAIN" while counselling or " JUST LIMIT ALCHOHOL INTAKE intake"?
UW seems to counsel everyone with any history of alcohol abuse to stop alcohol completely.
Uptodate says only people with liver disease, severe alcohol abuse should be counselled to stop since moderate alcohol con
what do you guys think??
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1-2 beers over the weekend is NOT abuse...
Abuse can be determined by the CAGE questionnaire
So I agree with UW to stop alcohol completely in ABUSE cases, of course in addition to the other cases u mentioned
In real life, a person who has a couple of drinks over the weekend, we do not usually counsel to stop that...
anyway I have a policy which is to think of the BIG picture ..I dont think if u put limit alcohol in that patient ur describing that it would count against u...
waiting for more feedback
GL
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thanks dalia..
Sorry I meant that UW CCS says counsel patient to STOP alcohol even if they drink 1-2 beers over the weekends..
Agree with you regarding the real life scenario. Thats why UW confused me.
Anyone else plz add..
thanks
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For CCS
If you are not clear about the amount of alcohol patient is taking like patient takes at weekends, patient takes occasionally whatever they say in history if it is not clear about the amount counsel quit alcohol.
If you dont you wont be discredited if patient drinks very less. But in CCS difficult to decide how much patient takes so better to counsel quit alcohol for all in suspicion.
Now if it says patient quit alcohol 4 yrs ago. Then also if you do quit alcohol its not suboptimal coz you still dont know whether patient really quit or not.
These are considered as neutral orders so you can order them at your own decision.
Hope this helps
Bumba
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In CCS, only thing we need to consider is if we will ever get penalized for our action or not. NON-INVASIVE actions such as counselling even if they are unnecessary are harmless to the patient and you will never be penalized for those. Invasive actions such as procedures , the penalty is very high and sometimes can lead to failure on a CCS case.
For example, you ordered stop alcohol or moderate alcohol in a case that does not concern alcohol use; it will not affect your score in either direction ( positive or negative). So stop worrying about ordering small non-invasive unnecessary actions that are harmless and that do not consume the simulated time ( reference is from Dr.Red ccs workshops).
On the other hand, in cases like DTs, patients who are on isoniazid , patients with alcogolic liver disease or pancreatitis must be counselled "no alcohol". In such cases, these counsel orders will boost your score.
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thanks guys!! very helpful..
