How Australian general practitioners engage in discussions about alcohol with their patients: a cross-sectional study

Article


Miller, Emma R., Ramsey, Imogen J., Tran, Ly Thi, Tsourtos, George, Baratiny, Genevieve, Manocha, Ramesh and Olver, Ian N. 2016. "How Australian general practitioners engage in discussions about alcohol with their patients: a cross-sectional study." BMJ Open. 6 (12), pp. 1-10. https://doi.org/10.1136/bmjopen-2016-013921
Article Title

How Australian general practitioners engage in discussions about alcohol with their patients: a cross-sectional study

ERA Journal ID200230
Article CategoryArticle
AuthorsMiller, Emma R. (Author), Ramsey, Imogen J. (Author), Tran, Ly Thi (Author), Tsourtos, George (Author), Baratiny, Genevieve (Author), Manocha, Ramesh (Author) and Olver, Ian N (Author)
Journal TitleBMJ Open
Journal Citation6 (12), pp. 1-10
Article Numbere013921
Number of Pages10
Year2016
PublisherBMJ
Place of PublicationUnited Kingdom
ISSN2044-6055
Digital Object Identifier (DOI)https://doi.org/10.1136/bmjopen-2016-013921
Web Address (URL)http://bmjopen.bmj.com/content/6/12/e013921
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.

Keywordsgeneral practitioners; alcohol; cancer prevention
ANZSRC Field of Research 2020420605. Preventative health care
420319. Primary health care
Byline AffiliationsFlinders University
University of Southern Queensland
University of Sydney
University of South Australia
Institution of OriginUniversity of Southern Queensland
Funding source
Australian Research Council (ARC)
Grant ID
LP120200175
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