Detection and management of alcohol misuse by general practitioners

Abstract

Introduction Alcohol misuse and related problems are common in Sri Lanka. The appropriateness of the primary care setting in dealing with alcohol misuse is well recognised, and general practitioners (GPs) constitute an important first contact setting.Methods One hundred and fifty randomly selected GPs practising in the Colombo and Gampaha districts were given a questionnaire to assess how they detect and manage alcohol misuse, and their attitudes towards persons who misuse alcohol.Results Seventy per cent of GPs responded [74 male; mean age 42 years (SD 6.7)]. Our results suggest that although a majority (81%) of GPs were frequently confronted with problems related to alcohol misuse, their efforts to detect the problem and knowledge regarding risk limits of alcohol consumption were poor. Only 25.7% had even heard of CAGE and MAST questionnaires. The majority of GPs felt inadequately trained to deal with alcohol misuse, but only a few made any self-directed efforts to improve their knowledge and skills regarding its management or referred their patients for specialised care. Participation in preventive programmes was minimal, and many GPs expressed negative attitudes towards persons misusing alcohol. ConclusionsThe ability of general practitioners to detect and alcohol misuse appears to be inadequate.

Current practices and attitudes of family physicians toward substance use disorders in the Emirate of Abu Dhabi: a cross-sectional survey in primary care

“…13 In another study conducted in Sri Lanka, the majority of GPs did not feel confident of their ability to detect (60%) or manage (55.2%) alcohol misuse. 18 In the PHC, the screening rate for HIV (75%, n=64), hepatitis B (65%, n=64) and hepatitis C (60.9%, n=64) was relatively similar to the Scottish study which indicated that GPs routinely provided screening for HIV (70.1%), hepatitis B (76.4%), and hepatitis C (70.1%). Regarding vaccination, Abu Dhabi FPs offered hepatitis B vaccination for 82.5% (n=57), a figure that was higher than for Scottish GPs (60.6%).…”

“…13 In another study, 19.1% always referred the patient to a physician, 17% to a psychiatrist, and 13.3% to a centre dealing with alcohol related problems. 18 The most commonly seen substance misuse in Abu Dhabi was alcohol, followed by tramadol and benzodiazepine. Others included antihistamines, gabapentin, opiates, and artane.…”

“…16 Another study found mixed attitudes among GPs towards patients who misused alcohol; 65% believed treating alcohol mis-users was rewarding, 48% believed it was time consuming and 54% saw alcohol misuse as presenting major problems. 18 In EAD, the majority of the FPs did not have any specialised training in treating SUDs. A total 66% would have liked to have had further training in screening and in the management of substance abuse.…”

Detection and management of alcohol misuse by general practitioners

“…They should also receive an enhanced training in motivational techniques in order to improve the management of patients with substance misuse and to achieve harm minimisation goals [5]. The findings of Gurugama and colleagues highlight the urgency of these measures in our country [1].…”

“…I read the article on "Detection and management of alcohol misuse by general practitioners" [1] with concern. The impact of socially unacceptable behavioural patterns on family health and well being following substance misuse, particularly alcohol, is immense, and could impair happiness [2].…”