General practice patients treated for substance use problems: a cross-national observational study in Belgium

Abstract

BackgroundGeneral Practitioners (GPs) are well placed to care for patients with (chronic) substance use problems. This pilot was carried out to study the feasibility and usefulness of a continuous surveillance of substance use problems among general practice patients. The objectives were (i) to describe variables with missing values exceeding 1% and whether patients were reported without substance-related problems; (ii) the profile and the magnitude of the patient population that is treated for substance use problems.MethodsObservational study by the Belgian Network of Sentinel General Practices (SGP) in 2013. Baseline (at the first encounter) and 7-month follow-up data were reported of all patients treated for substance use problems. Two main measurements were type of substance use and patient status at follow-up. Multiple logistic regression analysis was used to examine patient status at follow-up.ResultsOf 479 patients, 47.2% had problems with alcohol alone, 20.3% with prescription drugs, 16.7% with illicit drugs other than heroin or methadone and 15.9% with heroin or methadone. Problems with alcohol alone were more prevalent in Flanders (53.0%; 95% confidence interval (CI) 46.8–59.1%) than in Wallonia-Brussels (39.8%; 95% CI 33.1–46.8%), while problems with heroin or methadone were more prevalent in Wallonia-Brussels (27.0%; 95% CI 21.1–33.5%) than in Flanders (7.1%; 95% CI 4.3–10.9%). At follow-up, 32.8% of the patients had dropped out, 29.0% had discontinued GP treatment and 38.2% had continued GP treatment. Overall, 32.4% of 479 patients had continued GP treatment for substance use problems during the study period. In Wallonia-Brussels, this proportion was higher (42.7%; 95% CI 35.9–49.6%) than in Flanders (24.3%; 95% CI 19.2–29.8%).ConclusionsA continuous surveillance of the general practice population treated for substance use problems seems to be feasible and useful. The latter is suggested by the specific profile and the relative magnitude of the population. Inter-regional health system differences should be taken into account to estimate the epidemiology of substance use problems among general practice patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3885-0) contains supplementary material, which is available to authorized users.

General practice patients starting treatment for substance use problems: observations from two data sources across levels of care

“…The focus of the SGP pilot study was different but some core results are comparable, e.g. type of substance use, previous treatment episodes and regional differences [4]. The pilot showed that seven months after the baseline recording of new and ongoing episodes of GP-treatment, 21% of the patients who continued GP treatment also received specialist treatment.…”

“…Following a successful pilot study, the surveillance of new treatment episodes for substance use problems was taken up by the Network of Sentinel General Practices (SGP) in 2016, using an adapted TDI protocol [4]. Having data from both surveillance systems over two years (2016-2017), we decided to examine to what extent data from general practice patients from both sources are in agreement and whether differences are plausible or consistent with the body of evidence, e.g.…”

General practice patients starting treatment for substance use problems: observations from two data sources across levels of care

“…The focus of the SGP pilot study was different but some core results are comparable, e.g. type of substance use, previous treatment episodes and regional differences [5]. The pilot showed that seven months after the baseline recording of new and ongoing episodes of GP-treatment, 21% of the patients who continued GP treatment also received specialist treatment.…”

“…Overall, 95% of the general population in Belgium has a regular GP [4] Following a successful pilot study, the surveillance of new treatment episodes for substance use problems was taken up by the Network of Sentinel General Practices (SGP) in 2016, using an adapted TDI protocol [5] Having data from both surveillance systems over two years (2016-2017), we decided to examine to what extent data from general practice patients from both sources are in agreement and whether differences are plausible or consistent with the body of evidence, e.g. health problems presented in primary care are less severe/complex than those in higher, specialist care levels [6].…”

General practice patients starting treatment for substance use problems: observations from two data sources across levels of care

“…GPs play a key role in Belgian healthcare, even though patients are basically free to consult a care provider of their choice. Overall, 95% of the general population in Belgium has a regular GP [4].In 2016, following a successful pilot study, the surveillance of new treatment episodes for substance use problems was taken up by the Network of Sentinel General Practices (SGP), using an adapted TDI protocol [5]. Having acquired data from both surveillance systems over a period of 2 years (2016-2017), we decided to examine to what extent general practice patients data from both sources are in agreement and whether differences are plausible or consistent with the body of evidence, e.g.…”