Clinical reasoning, clinical trials and risky drinkers in everyday primary care: A qualitative study of British general practitioners

May, Carl; Rapley, Tim; Kaner, Eileen

doi:10.1080/16066350600609883

Cited by 22Substance Abuse Treatment and OutcomesPatient-Provider Communication in HealthcareLanguage, Discourse, Communication Strategies

Clinical reasoning, clinical trials and risky drinkers in everyday primary care: A qualitative study of British general practitioners

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May, Carl, Rapley, Tim, Kaner, Eileen·2006·Addiction Research & Theory

DOI 10.1080/16066350600609883

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Abstract

Alcohol and other substance misuse problems have historically been seen as refractory in primary care, but in the past 20 years Brief Interventions have come to be seen as an important and effective response to a range of problems around ‘risky drinking’. Proponents of brief interventions have argued that these interventions are best accomplished in the community, but that primary health care professionals resist using them. This qualitative study investigated responses to alcohol problems in a maximum variation sample of 28 primary care professionals in and around a northern English city. We found clinicians negotiating alcohol problems using interactional techniques that integrated elements of brief interventions, and which fitted these to the interactional and temporal order of clinical encounters and physician–patient relationships in primary care. Central to these accounts was the problem of finding an interactional solution that drew together notions of what was both ethically and practically possible in any given encounter.

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GPs and nurses often cited improving professional teamwork as a facilitator.
“GPs and nurses often cited improving professional teamwork (e.g. having a practice nurse delivering SBI, having receptionists giving patients screening tools) as a facilitator [39, 41, 54, 70, 71, 73, 76, 80, 91, 93, 97, 99].”
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 [91]
In 4 quantitative and 4 qualitative studies, GPs were sceptical that patients would follow their advice.
“In 4 quantitative and 4 qualitative studies GPs were sceptical that patients would follow their advice [20, 42, 47, 49, 78, 83, 91, 107];”
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 [91]
In 10 qualitative studies, primary health care providers considered asking about alcohol a delicate task because alcohol is viewed as a sensitive issue, making them feel uncomfortable.
“In 10 qualitative studies, primary health care (PHC) providers considered asking about alcohol a delicate task because alcohol is viewed as a sensitive issue, making them feel uncomfortable [37, 41, 54, 77, 89, 91, 97, 99, 109, 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 [91]

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Additional file 3 of 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
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Additional file 4 of 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
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Authors: May, C., Rapley, T., & Kaner, E.
Affiliations: Newcastle University (GB)
Corresponding author: May, Carl
ORCID: May, Carl
Rapley, Tim
Kaner, Eileen
Venue: Addiction Research & Theory
Publisher: Informa UK Limited
Published: 2006-01
Volume: 14
Issue: 4
Pages: 387-397
ISSN: 1058-6989 (ISSN-L)
1606-6359
1476-7392
DOI: 10.1080/16066350600609883
OpenAlex: W2124907218
Cited by: 22
References: 39
Citations by year: 2021: 6 · 2020: 1 · 2017: 2 · 2014: 1 · 2012: 3
FWCI: 1.23
Type: journal article
Language: en
Open access: green
doi.org
Locations: Addiction Research & Theory (publishedVersion)
ePrints Soton (University of Southampton) (submittedVersion)
Newcastle University ePrints (Newcastle Univesity)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
Social Sciences › Arts and Humanities › Language and Linguistics › Language, Discourse, Communication Strategies
Keywords: hazardous drinking, brief intervention, alcohol abuse, general practitioners, primary care, clinical reasoning, physician-patient relationship, patient encounters, clinical ethics, alcohol screening

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Clinical reasoning, clinical trials and risky drinkers in everyday primary care: A qualitative study of British general practitioners

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