OP35 Screening interventions for problem gambling in health, care and support settings – a systematic review

Abstract

Background Since the relaxing of gambling laws in 2005, gambling harm has become a serious and worsening public health problem in the UK. Health and other care settings have the potential to act as screening sites in order to identify and support gamblers who may be at high risk of experiencing gambling related harm. This study aims to identify interventions to screen for risk of gambling related harm in the general population which may be delivered in health, care and support settings. Methods Systematic review and narrative synthesis. Searches of key databases and grey sources since 2012 were undertaken in October 2019. We included all studies (with no limit on design) which related the inclusion of screening and support for (previously unidentified) problem gambling in users of health, care and support services. The findings were synthesised narratively and a typology of interventions and supporting evidence was developed. Results Electronic database searches generated at total of 5826 unique hits. Nine studies published 2013–2019, along with thirteen grey literature documents met our eligibility criteria and were included in the synthesis. The published studies originated in the UK (3), Sweden (2), US (1), and Australia (3). Grey literature was from the US. The papers in academic journals (n=9) provided evaluative data from interventions, or qualitative data on practitioners’ views. Three of these papers evaluated the use of screening, brief intervention and referral to treatment (SBIRT) approaches to identify and treat people experiencing or at risk of problem gambling and related harms. These were delivered in general practice, a mental health support service, and a substance abuse treatment service. Six papers provided evidence regarding the feasibility and acceptability of delivering interventions in settings including general practice, mental health services, consumer credit counselling and social work. Evidence of feasibility in varied contexts was further supported by grey literature reports describing the implementation of interventions such as training materials, and transfer of the use of SBIRT from substance abuse populations by practitioners. Discussion Health, care and support services offer potentially important contexts in which to identify and offer support to people who are at risk of becoming problem gamblers. Screening intervention approaches (such as SBIRT) used with people who have other addictions, appear to be feasible and acceptable in a range of community and healthcare settings for those at risk of gambling harm. However, evidence of effectiveness and cost-effectiveness in this population is currently limited.