General Practitioners, Prevention and Alcohol - a powerful cocktail? Facilitators and inhibitors of practising preventive medicine in general and early intervention for alcohol in particular: a 12-nation key informant and general practitioner study
Abstract
This study reports a qualitative investigation of the views of key informants (KIs) and general practitioners (GPs) on the nature and extent of preventive medicine and early alcohol intervention in general practice and the current barriers and potential facilitating factors that influence practice. Sixty-seven KIs and 126 GPs were interviewed in 12 countries. There was strong personal and professional support for GP-delivered preventive medicine in general and early intervention for alcohol problems in particular. Opinions differed on whether national health policies encouraged or discouraged GPs to do more preventive medicine. The two key areas identified for prevention were smoking and alcohol, although all but two countries thought that alcohol was the most difficult area for GPs to discuss with patients. KIs and GPs identified similar barriers and facilitating factors. The main barriers were time constraints, lack of financial reimbursement or incentives and insufficient training and education. The main facilitating factors were more societal concern about alcohol, proactive patients, more time, financial reimbursement and supportive government policy.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
More information about the effectiveness of brief interventions and feedback on successful cases were identified as implementation facilitators.
“More information about the effectiveness of brief interventions [23, 36, 39, 47, 78, 84, 87, 92] and feedback on successful cases [71, 109] were identified as implementation facilitators.”
For some doctors and nurses, alcohol SBI was too time-consuming and they were already too busy dealing with other problems.
“For some doctors and nurses, alcohol SBI was too time-consuming [72, 95, 106] and they were already too busy dealing with other problems [23, 47, 78, 83, 92, 106].”
More time per consultation, more experience in delivering brief interventions, and simpler screening processes were reported as facilitators.
“More time per consultation [39, 70, 80, 92, 97], more experience in delivering brief interventions [93], and simpler screening processes (e.g. short and simple screening tools, giving patients self-report questionnaires) [39] were reported as facilitators.”
Alcohol was not a goal priority for GPs because they were too busy, which makes them neglect alcohol issues in favour of other presenting problems.
“Alcohol was not a goal priority for GPs because they were too busy, which makes them neglect alcohol issues in favour of other presenting problems [23, 47, 78, 83, 92, 105, 106].”
Both GPs and nurses in 6 qualitative studies expressed concern about negative reactions from patients when discussing alcohol issues.
“Both GPs and nurses in 6 qualitative studies expressed their concern about negative reactions from patients when discussing alcohol issues [49, 84, 86, 89, 92, 105].”
Having these resources and displaying information in the waiting room were reported as facilitators in several studies.
“Having these resources and displaying information in the waiting room (e.g. posters) were reported as facilitators in several studies [20, 23, 37, 39, 47, 55, 78, 92].”
Cites
Promoting health and preventing disease in health care settings: An analysis of barriers
Orlandi, M. A. (1987) · Preventive Medicine · doi:10.1016/0091-7435(87)90011-9 · Cited by 148 · see citing works
Managing alcohol problems in general practice.
Anderson, P. (1985) · BMJ · doi:10.1136/bmj.290.6485.1873 · Cited by 122 · see citing works
Doctors' willingness to intervene in patients' drug and alcohol problems
Roche, A. M., & Richard, G. P. (1991) · Social Science & Medicine · doi:10.1016/0277-9536(91)90010-a · Cited by 68 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Kaner, E. F., Beyer, F. R., Garnett, C., Crane, D., Brown, J., Muirhead, C., Redmore, J., O'Donnell, A., Newham, J. J., de Vocht, F., et al. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011479.pub2 · Cited by 308 · see citing works
Can stand‐alone computer‐based interventions reduce alcohol consumption? A systematic review
Khadjesari, Z., Murray, E., Hewitt, C., Hartley, S., & Godfrey, C. (2011) · Addiction · doi:10.1111/j.1360-0443.2010.03214.x · Cited by 208 · see citing works
Rosário, F., Santos, M. I., Angus, K., Pas, L., Ribeiro, C., & Fitzgerald, N. (2021) · Implementation Science · doi:10.1186/s13012-020-01073-0 · Cited by 141 · see citing works
“McAvoy [92] 2001 Australia, Canada, Denmark, France, Hungary, Italy, New Zealand, Norway, Poland, Russia English Semi-structured interviews 126 Fair”
Brown, J., West, R., Angus, C., Beard, E., Brennan, A., Drummond, C., Hickman, M., Holmes, J., Kaner, E., & Michie, S. (2016) · British Journal of General Practice · doi:10.3399/bjgp16x683149 · Cited by 96 · see citing works
Anderson, P. (2003) · Alcohol and Alcoholism · doi:10.1093/alcalc/agg119 · Cited by 97 · see citing works
Anderson, P., Wojnar, M., Jakubczyk, A., Gual, A., Reynolds, J., Segura, L., Sovinova, H., Csemy, L., Kaner, E., Newbury-Birch, D., et al. (2014) · Alcohol and Alcoholism · doi:10.1093/alcalc/agu043 · Cited by 83 · see citing works
Rosário, F., Santos, M. I., Angus, K., Pas, L., & Fitzgerald, N. (2018) · Acta Médica Portuguesa · doi:10.20344/amp.9753 · Cited by 16 · see citing works
Rosário, F., Vasiljevic, M., Pas, L., Fitzgerald, N., & Ribeiro, C. (2019) · Family Practice · doi:10.1093/fampra/cmy062 · Cited by 11 · see citing works
- Authors
- R. McAvoy, R. J. D.
- Venue
- Drugs: Education, Prevention and Policy
- Publisher
- Informa UK Limited
- Published
- 2001-01
- Volume
- 8
- Issue
- 2
- Pages
- 103-117
- ISSN
- 0968-7637 (ISSN-L)
- 1465-3370
- OpenAlex
- W2115034167
- Cited by
- 42
- References
- 3
- Citations by year
- 2024: 1 · 2021: 3 · 2018: 3 · 2017: 2 · 2016: 7 · 2015: 5 · 2014: 4 · 2013: 1 · 2012: 2
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drugs Education Prevention and Policy (publishedVersion)
- Funders
- Generalitat de Catalunya
- 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 › Health Professions › General Health Professions › Primary Care and Health Outcomes
- Keywords
- general practitioners, preventive medicine, alcohol problems, barriers and facilitators, smoking prevention, health policy, financial incentives, professional training, time constraints, general practice
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
