Screening and brief intervention for excessive alcohol use: qualitative interview study of the experiences of general practitioners
- PMID: 12386040
- PMCID: PMC129636
- DOI: 10.1136/bmj.325.7369.870
Screening and brief intervention for excessive alcohol use: qualitative interview study of the experiences of general practitioners
Abstract
Objective: To explore the suitability of a screening based intervention for excessive alcohol use by describing the experiences of general practitioners who tried such an intervention in their everyday practice.
Design: Qualitative interviews with general practitioners who had participated in a pragmatic study of a combined programme of screening and a brief intervention for excessive alcohol use. Doctors were interviewed either individually or in focus groups. A computer based, descriptive, phenomenological method was used to directly analyse the digitally recorded interviews.
Setting and participants: 24 of 39 general practitioners in four Danish counties who volunteered to take part in the pragmatic study were interviewed.
Results: The doctors were surprised at how difficult it was to establish rapport with the patients who had a positive result on the screening and to ensure compliance with the intervention. Although the doctors considered the doctor-patient relationship robust enough to sustain targeting of alcohol use, they often failed to follow up on initial interventions, and some expressed a lack of confidence in their ability to counsel patients effectively on lifestyle issues. The doctors questioned the rationale of screening in young drinkers who may grow out of excessive drinking behaviour. The programme needed considerable resources, and it interrupted the natural course of consultations and was inflexible. The doctors could not recommend the screening and brief intervention programme, although they thought it important to counsel their patients on drinking.
Conclusions: Screening for excessive alcohol use created more problems than it solved for the participating doctors. The results underline the value of carrying out pragmatic studies on the suitability of seemingly efficacious healthcare programmes.
Comment in
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General practitioner screening for excessive alcohol use. Paper enables open debate about a complex intervention.BMJ. 2003 Feb 8;326(7384):336. BMJ. 2003. PMID: 12574053 No abstract available.
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General practitioner screening for excessive alcohol use. General practitioners' experiences are important.BMJ. 2003 Feb 8;326(7384):336. BMJ. 2003. PMID: 12575715 No abstract available.
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General practitioner screening for excessive alcohol use. Brief screening tools should be used in general practice.BMJ. 2003 Feb 8;326(7384):336. BMJ. 2003. PMID: 12575716 Free PMC article. No abstract available.
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Some screening is necessary to identify excessive drinkers early in primary care.BMJ. 2003 Mar 8;326(7388):550. doi: 10.1136/bmj.326.7388.550. BMJ. 2003. PMID: 12623922 Free PMC article. No abstract available.
References
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- Babor TF, Higgins-Biddle JC. Alcohol screening and brief intervention: dissemination strategies for medical practice and public health. Addiction. 2000;95:677–686. - PubMed
-
- Hansen LJ, Olivarius N, Beich A, Barfod S. Encouraging GPs to undertake screening and a brief intervention in order to reduce problem drinking: a randomized controlled trial. Fam Pract. 1999;16:551–557. - PubMed
-
- World Health Organization Collaborative Project on Identification and Management of Alcohol-Related Problems in Primary Health Care. Development of country-wide strategies for implementing early identification and brief alcohol intervention in primary health care. www.who.alcohol-phaseiv.com/index.htm (accessed 26 May 2002).
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- Saunders JB, Aasland OG. Geneva: World Health Organization; 1987. WHO collaborative study on identification and treatment of persons with harmful alcohol consumption. Report on phase 1: developement of a screening instrument.
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