Factors influencing GPs' decisions regarding screening for high alcohol consumption: a focus group study in Swedish primary care

Johansson, K.; Bendtsen, P.; Åkerlind, I.

doi:10.1016/j.puhe.2004.12.006

Cited by 33Substance Abuse Treatment and OutcomesHealth Promotion and Cardiovascular PreventionAlcohol Consumption and Health Effects

Factors influencing GPs' decisions regarding screening for high alcohol consumption: a focus group study in Swedish primary care

Johansson, K., Bendtsen, P., Åkerlind, I.·2005·Public Health

DOI 10.1016/j.puhe.2004.12.006

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Abstract

Objective The aim of this study was to explore factors that influence general practitioners' (GPs') decisions regarding screening for high alcohol consumption.Methods GPs working at three primary healthcare centres in Sweden participated in focus group interviews. The interviews were recorded and transcribed verbatim, and a deductive framework approach was used for the analysis.Results The majority of the participating GPs did not believe in asking all patients about their alcohol consumption. Reported factors that influenced how many and which patients were questioned about alcohol consumption were time, age of the patient, consultation setting, patient-physician relationship, what symptoms the patient presented with, and knowledge of measures if patients appear to have a high alcohol consumption. Thus, alcohol screening and intervention were not performed in all patient groups as was originally intended, but were performed in limited groups of patients such as those with alcohol-related symptoms.Conclusions Although the number of participants in this study was small and the conclusions cannot be generalized, the results provide some valuable insights into why GPs are hesitant to engage in screening for high alcohol consumption. Since prevention of alcohol-related health problems is an important public health issue, many different screening and intervention strategies have to be formulated and evaluated in order to reach patients with both hazardous and harmful alcohol consumption within the healthcare system. Screening all consecutive patients for a limited period or screening patient groups known to include a fairly high frequency of high alcohol consumers are two ways of limiting the time requirements and increasing role legitimacy. Still, there is a need for a broader public health strategy involving many players in the community in alcohol preventive measures, especially in more primary preventive approaches.

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Asking patients about alcohol was found easy to forget in 2 qualitative studies on GPs from the Nordic countries.
“Asking patients about alcohol was found easy to forget in 2 qualitative studies on GPs from the Nordic countries [41, 74].”
From Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework (2021) · cites this paper as [74]
Four studies from the Nordic countries mentioned that GPs asked their patients about alcohol only if there was something that made them suspect the patient was a heavy drinker.
“Four studies (3 qualitative and 1 quantitative) from the Nordic countries mentioned that GPs asked their patients about alcohol only if there was something that made them suspect the patient was a heavy drinker [38, 41, 42, 74].”
From Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework (2021) · cites this paper as [74]
Six pieces of data from 3 qualitative, 1 quantitative and 1 mixed methods studies alluded that both GPs' and nurses' screening activities were influenced by patients' characteristics.
“Six pieces of data from 3 qualitative, 1 quantitative and 1 mixed methods studies alluded that both GPs and nurses screening activities were influenced by patients’ characteristics [41, 51, 74, 105, 115].”
From Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework (2021) · cites this paper as [74]
GPs in 3 qualitative studies mentioned that implementation strategies for routine screening of at-risk drinkers were lacking.
“GPs in 3 qualitative studies mentioned that implementation strategies for routine screening of at-risk drinkers were lacking [74, 103, 109].”
From Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework (2021) · cites this paper as [74]
Data mainly from qualitative studies suggested that GPs and nurses do not screen systematically for alcohol but only when they suspected heavy consumption or when the patient's complaint was likely to be alcohol-related.
“Data, mainly from qualitative studies, suggested that GPs and nurses do not screen systematically for alcohol but only when they suspected heavy consumption, or when the patient’s complaint was likely to be alcohol-related [41, 42, 58, 67, 72–74, 88].”
From Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM-B system and Theoretical Domains Framework (2021) · cites this paper as [74]

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Authors: Johansson, K., Bendtsen, P., & Åkerlind, I.
Affiliations: Linköping University (SE)
Corresponding author: Johansson, K.
ORCID: Johansson, K.
Bendtsen, P.
Venue: Public Health
Publisher: Elsevier BV
Published: 2005-09
Volume: 119
Issue: 9
Pages: 781-788
ISSN: 0033-3506 (ISSN-L)
DOI: 10.1016/j.puhe.2004.12.006
OpenAlex: W2087297293
Cited by: 33
References: 37
Citations by year: 2024: 1 · 2023: 1 · 2022: 1 · 2021: 6 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 2 · 2014: 1 · 2013: 3 · 2012: 1
FWCI: 0.96
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Public Health (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords: alcohol screening, general practitioners, physician decision-making, primary care, alcohol-related symptoms, physician-patient relationship, role legitimacy, alcohol prevention
MeSH terms: Alcohol Drinking, Alcoholism, Attitude of Health Personnel, Counseling, Decision Making, Diagnostic Tests, Routine, Humans, Medical History Taking, Physician-Patient Relations, Practice Patterns, Physicians', Physicians, Family, Primary Health Care, Sweden, Focus Groups

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Factors influencing GPs' decisions regarding screening for high alcohol consumption: a focus group study in Swedish primary care

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