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How Australian general practitioners engage in discussions about alcohol with their patients: a cross-sectional study
  1. Emma R Miller1,
  2. Imogen J Ramsey1,
  3. Ly Thi Tran1,
  4. George Tsourtos1,
  5. Genevieve Baratiny2,
  6. Ramesh Manocha3,
  7. Ian N Olver4
  1. 1Department of Public Health, Flinders University, Adelaide, South Australia, Australia
  2. 2University of Southern Queensland, Toowoomba, Queensland, Australia
  3. 3University of Sydney, Sydney, New South Wales, Australia
  4. 4Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
  1. Correspondence to Dr Emma R Miller; emma.miller{at}flinders.edu.au

Abstract

Objective This study aimed to investigate factors that inhibit and facilitate discussion about alcohol between general practitioners (GPs) and patients.

Design Data analysis from a cross-sectional survey.

Setting and participants 894 GP delegates of a national health seminar series held in five capital cities of Australia in 2014.

Main outcome measures Likelihood of routine alcohol enquiry; self-assessed confidence in assessing and managing alcohol issues in primary healthcare.

Results Most GPs (87%) reported that they were likely to routinely ask patients about their alcohol consumption and had sufficient skills to manage alcohol issues (74%). Potential barriers to enquiring about alcohol included perceptions that patients are not always honest about alcohol intake (84%) and communication difficulties (44%). ‘I usually ask about alcohol’ was ranked by 36% as the number one presentation likely to prompt alcohol discussion. Altered liver function test results followed by suspected clinical depression were most frequently ranked in the top three presentations. Suspicious or frequent injuries, frequent requests for sickness certificates and long-term unemployment were ranked in the top three presentations by 20% or less. Confidence in managing alcohol issues independently predicted likelihood to ‘routinely ask’ about alcohol consumption. Lack of time emerged as the single most important barrier to routinely asking about alcohol. Lack of time was predicted by perceptions of competing health issues in patients, fear of eliciting negative responses and lower confidence in ability to manage alcohol-related issues.

Conclusions Improving GPs' confidence and ability to identify, assess and manage at-risk drinking through relevant education may facilitate greater uptake of alcohol-related enquiries in general practice settings. Routine establishment of brief alcohol assessments might improve confidence in managing alcohol issues, reduce the time burden in risk assessment, decrease potential stigma associated with raising alcohol issues and reduce the potential for negative responses from patients.

  • PREVENTIVE MEDICINE
  • PRIMARY CARE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors ERM developed and implemented the survey, coordinated the statistical analysis and participated in the drafting of the manuscript. IJR participated in the drafting of the manuscript and LTT undertook all preliminary analyses and contributed to the drafting of the manuscript. GT contributed to the preliminary analysis and the drafting of the manuscript. RM participated in the survey design, administered and collated paper survey data and contributed to manuscript. GB and INO participated in the design of the study, commented on the analysis and helped draft the manuscript. All authors read and approved the final manuscript.

  • Funding This work was supported by the Australian Research Council, grant number LP 120200175, and Linkage Partners Cancer Council Australia and Drug and Alcohol Services of South Australia.

  • Competing interests None declared.

  • Ethics approval University of Adelaide Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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