Intervention for Excessive Alcohol Consumption in Primary Health Care: Attitudes and Practices of English General Practitioners

Abstract

General practitioners' (GPs') recognition of, attitudes towards, and intervention for, excessive drinking and alcohol problems among their patients were assessed in a postal questionnaire survey. Levels of recognition of, and intervention for, excessive drinking by GPs were low. GPs did not routinely enquire about alcohol and had managed only small numbers of patients specifically for excessive drinking or alcohol problems in the previous year. Enquiry about alcohol issues was elicited mainly by physical symptoms or by new patient registrations. Although 83% of GPs felt prepared to counsel excessive drinkers, only 21% felt effective in helping patients reduce consumption. Over the past 10 years, there appears to have been an increase in numbers of GPs who feel that they should be working with alcohol issues, but fewer GPs perceive themselves as being effective in this work. The main barriers to brief alcohol intervention were given as insufficient time and training, and lack of help from government policy; the main incentives related to availability of appropriate support services and proven efficacy of brief interventions.

Sex and age differences in the early identification and treatment of alcohol use: a population‐based study of patients with alcoholic cirrhosis

“…However, in relative terms when we examined men and women with alcoholic cirrhosis in comparison to general population, the increase in health service use associated with the disease was more dramatic in men than women. In terms of alcohol use recording and intervention delivery, consistent with our results, a number of studies have reported that the implementation of brief alcohol interventions within healthcare settings is generally slow in the UK as well as internationally (36)(37)(38)(39).…”

Intervenciones breves en alcohol como rutina diaria. Proyecto de investigación acción de directrices para atención primaria

“…Our finding that health professionals prefer opportunistic to systematic screening is similar than that of other researchers (Kaner et al 1999, Kaner et al 2001, and perceived lack of time may have led to the wish to have simple patient instructions, in the form of information leaflet.…”

“…In spite of all the efforts to promote brief intervention, activity has remained low (Adams et al 1997, Kaner et al 1999, Andréasson et al 2000, Beich et al 2002. The possible reasons may lie in insufficient commitment of opinion leaders, lack of time and resources, and obstacles like attitudes and poor skills and knowledge (Weller et al 1992, McDuffy et al1995, Roche et al 1995, Adams et al 1997, Kääriäinen et al 2001, Roche and Freeman 2004.…”

Commentary on ‘The research translation problem: Alcohol screening and brief intervention in primary care – Real world evidence supports theory’

“…While considerable evidence outlines the benefits of SBI for problem alcohol use in general practice, observed screening and intervention rates are low and barriers to implementing this evidence are likely (Kaner, Heather, McAvoy, Lock, & Gilvarry, 1999;Rumpf, Bohlmann, Hill, Hapke, & John, 2001). …”