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

Miller, Emma R. and Ramsey, Imogen J. and Tran, Ly Thi and Tsourtos, George and Baratiny, Genevieve and 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.

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

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.

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.

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.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: 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.
Faculty / Department / School: Current - Institute for Agriculture and the Environment
Date Deposited: 24 Feb 2017 02:58
Last Modified: 15 May 2017 04:05
Uncontrolled Keywords: general practitioners; alcohol; cancer prevention
Fields of Research : 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111716 Preventive Medicine
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111717 Primary Health Care
Socio-Economic Objective: C Society > 92 Health > 9202 Health and Support Services > 920203 Diagnostic Methods
Funding Details:
Identification Number or DOI: 10.1136/bmjopen-2016-013921

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