A survey of GPs’ knowledge, attitudes and practices on alcohol interventions

'A survey of general practitioners’ knowledge, attitudes and practices regarding the prevention and management of alcohol-related problems: an update of a World Health Organisation survey ten years on' has been released by the AERC.

See Alcohol Insight 69 for the key findings or download the full report

The study, conducted by leading researchers in the UK field of alcohol treatment and interventions, explores some of the key findings and perceptions of General Practitioners (GPs) as a key context for identifying and responding to alcohol problems.

Key findings and issues include:

• 94% of GPs were ‘prepared’ or ‘very prepared’ to counsel patients
• 60% of GPs felt ‘effective’ or ‘very effective’ in helping patients change alcohol consumption, with this proportion rising to 82% if  given adequate information and training
• Over a half (52%) had received less than 4 hours of post-graduate training, CME or clinical supervision on alcohol-related issues and 12% had received no such training
• The main barriers to involvement in alcohol intervention were that GPs were too busy (63%), that GPs were not trained in counselling for reducing alcohol consumption (57%) and that the current GMS contract did not encourage work with alcohol problems (48%).
• The main incentives for this work were if support services were more readily available (87%), if early intervention was proven to be successful (81%) and if patients requested alcohol-related advice (80%)

Key implications for policy and practice include:

• GPs are not routinely asking patients about alcohol and most do so only in response to physical indicators
• The provision of support to facilitate GPs in asking patients about alcohol is recommended. GPs report low numbers of patients being managed for alcohol
• Levels of identification could be increased through the adoption of screening for alcohol problems into the GP contract
• Levels of postgraduate training in treating alcohol reported by GPs are low and lower than ten years previously. Further training should be made available to GPs.
• Inclusion of alcohol treatment in the GMS contract, and in the Quality and Outcomes Framework were possible key options for improving alcohol responses

The report seems to indicate there is still significant gains to be made in improving the role of Primary Care in identifying and responding to alcohol problems. However it does not appear to reflect the development of schemes such as Locally Enhanced Services (LES) and the national Direct Enhanced Services (DES) which have been increasingly implemented in recent years. The DES offers GP practices an incentive to screen new registrations for alcohol and has been extended for 2010/11. However there have been reports that local LES contracts, which include specific requirements for delivering brief interventions rather than only screening, are more effective.

See the Primary care service framework: Alcohol for commissioning guidance on alcohol interventions in Primary Care.