Detection and management of alcohol use disorders in German primary care influenced by non-clinical factors
Abstract
AIMS: The primary objective was to assess the proportion of detected and correctly referred patients in German primary care. The secondary objective was to identify patient and practitioner characteristics that predict detection and correct referral. METHODS: In this clustered cross-sectional survey in German primary care, 3003 patients were consecutively invited to participate, and were asked to fill in a standardized health questionnaire. They were then screened for problematic alcohol consumption using the Alcohol Use Disorders Identification Test. The physicians recorded their assessment of the presence of any alcohol use disorder and documented the treatment course of all identified patients for 3 months. RESULTS: Correctly identified problem drinkers were 38.6% in a per-protocol analysis and 33.6% using a worst-case scenario. Referral behaviour of physicians was in conformity with current practice guidelines in 64.6% of the documented cases and 27.0% in a worst-case scenario. Several patient (e.g. sex, age) and practitioner characteristics (e.g. age), which influence the diagnosis and referral of patients, could be identified. CONCLUSIONS: There is a clear need to increase the special diagnostic and therapeutic skills of general practitioners so that they may be able to indicate and perform secondary prevention. Further research should focus on the likely effects of the implementation of these diagnostic and management tools.
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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 [51]
The Detection and referral of patients section (p. 5) reports that patient characteristics, including sex and frequency of GP visits, were associated with GPs’ detection of problem drinkers. This supports the GP portion of the claim, but the paper does not study nurses’ screening activities; its measured outcome is GP detection rather than screening activity generally. (LLM, conf=0.84)
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Research works printed but not linked: 1
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“Demographical characteristics of the PHC professionals Germany(1); Norway(1) [51, 100]”
BackgroundInfluentialWilson, G. B., Lock, C. A., Heather, N., Cassidy, P., Christie, M. M., & Kaner, E. F. S. (2011) · Alcohol and Alcoholism · doi:10.1093/alcalc/agr067 · Cited by 112 · see citing works
- Authors
- Berner, M. M., Harter, M., Kriston, L., Lohmann, M., Ruf, D., Lorenz, G., & Mundle, G.
- Affiliations
- University Medical Center Freiburg (DE)
- Universitätsklinikum Tübingen (DE)
- Corresponding author
- Berner, M. M.
- Venue
- Alcohol and Alcoholism
- Publisher
- Oxford University Press (OUP)
- Published
- 2007-05-21
- Volume
- 42
- Issue
- 4
- Pages
- 308-316
- ISSN
- 0735-0414 (ISSN-L)
- 1464-3502
- OpenAlex
- W1979576672
- Cited by
- 35
- References
- 30
- Citations by year
- 2025: 2 · 2024: 1 · 2021: 7 · 2019: 3 · 2018: 2 · 2017: 1 · 2016: 1 · 2014: 2 · 2013: 3 · 2012: 3
- FWCI
- 1.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alcohol and Alcoholism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bundesministerium für Bildung und Forschung
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- alcoholism, primary care, alcohol screening, referral behavior, general practitioners, auditing, secondary prevention, diagnostic accuracy, clinical guidelines, patient characteristics, physician characteristics
- MeSH terms
- Adult, Alcoholism, Analysis of Variance, Female, Germany, Humans, Longitudinal Studies, Male, Middle Aged, Primary Health Care, Quality Control, Referral and Consultation, Socioeconomic Factors, Guidelines as Topic
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