Intervention against Excessive Alcohol Consumption in Primary Health Care: A Survey of GPs' Attitudes and Practices in England 10 Years On
Open accessAbstract
AIMS: To ascertain the views of general practitioners (GPs) regarding the prevention and management of alcohol-related problems in practice, together with perceived barriers and incentives for this work; to compare our findings with a comparable survey conducted 10 years earlier. METHODS: In total, 282 (73%) of 419 GPs surveyed in East Midlands, UK, completed a postal questionnaire, measuring practices and attitudes, including the Shortened Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ). RESULTS: GPs reported lower levels of post-graduate education or training on alcohol-related issues (<4 h for the majority) than in 1999 but not significantly so (P = 0.031). In the last year, GPs had most commonly requested more than 12 blood tests and managed 1-6 patients for alcohol. Reports of these preventive practices were significantly increased from 1999 (P < 0.001). Most felt that problem or dependent drinkers' alcohol issues could be legitimately (88%, 87%) and adequately (78%, 69%) addressed by GPs. However, they had low levels of motivation (42%, 35%), task-related self-esteem (53%, 49%) and job satisfaction (15%, 12%) for this. Busyness (63%) and lack of training (57%) or contractual incentives (48%) were key barriers. Endorsement for government policies on alcohol was very low. CONCLUSION: Among GPs, there still appears to be a gap between actual practice and potential for preventive work relating to alcohol problems; they report little specific training and a lack of support. Translational work on understanding the evidence-base supporting screening and brief intervention could incentivize intervention against excessive drinking and embedding it into everyday primary care practice.
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In 9 survey studies, the majority of GPs and nurses who received training reported that those programmes lasted less than four hours.
“In 9 survey studies, the majority of the GPs and nurses who received training reported that those programmes lasted less than four hours [20, 23, 44, 46, 47, 70, 76, 78, 79].”
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 [23]
In Results, under “Medical education and training on alcohol,” 52% of surveyed GPs reported less than four hours of training, but that group included 34 who reported no training at all. Excluding those 34 leaves 112 of 248 GPs who received training—less than a majority. This paper surveyed GPs, not nurses; the nine-study count belongs to the citing sentence as a whole. (LLM, conf=0.90)
Experimental — accuracy not yet measuredAlcohol 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].”
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 [23]
The Abstract identifies busyness as a barrier, and the Discussion says GPs may be too busy to intervene and that routine alcohol enquiry is not mainstream. The paper does not establish that GPs prioritize other presenting problems over alcohol issues, or that busyness is the reason for that specific choice. The indexed passages have no page numbers. (LLM, conf=0.84)
Experimental — accuracy not yet measuredHaving 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].”
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 [23]
The Results section (Table 4; page not provided) identifies readily available counselling materials and screening questionnaires as perceived incentives for alcohol intervention. Neither that passage nor the additional passages retrieved from our copy report waiting-room information or posters as a facilitator, so that part of the attributed claim is unsupported. (LLM, conf=0.84)
Experimental — accuracy not yet measuredData from 6 quantitative and 1 qualitative study indicated that GPs believed in the effectiveness of brief interventions.
“data from 6 quantitative and 1 qualitative studies point otherwise [23, 64, 70, 73, 86, 106, 110].”
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 [23]
The Discussion reports that GPs generally felt they could and should intervene for alcohol problems, and the Results report that most felt able to address them. Neither passage establishes that GPs believed brief interventions were effective; the Introduction says GPs in the earlier survey perceived a lack of effectiveness in counselling patients. The ‘6 quantitative and 1 qualitative’ count describes the citing paper’s group of studies, not this survey alone. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe majority of GPs in 4 of 6 quantitative studies reported feeling comfortable asking about alcohol.
“Notwithstanding, the majority of the GPs in 4 from a total of 6 quantitative studies reported feeling comfortable asking about alcohol [23, 47, 56, 78, 83, 116].”
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 [23]
In Results, ‘Attitudes to working with different types of drinker’ (page unavailable), 88% and 87% of GPs agreed it was legitimate to ask problem and dependent drinkers, respectively, about alcohol consumption. That supports a majority holding a favourable attitude toward asking, but the paper does not report whether they felt comfortable doing so or establish the citing sentence’s ‘4 of 6 studies’ count. (LLM, conf=0.78)
Experimental — accuracy not yet measured
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].”
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 [23]
In Results, Table 3 (page not provided), 63% of surveyed GPs agreed that doctors were too busy dealing with patients’ presenting problems to intervene for alcohol. The paper supports this barrier for doctors, but its survey did not assess nurses, so it does not support extending the finding to them. (LLM, conf=0.88)
Experimental — accuracy not yet measuredBetter co-operation with specialized services, involving other professionals in general practice, public health educational campaigns, and more media attention were among the most commonly cited facilitators.
“Better co-operation with specialized services [20, 39, 59, 60, 80], involving other professionals in general practice (e.g. an addiction consultant or a specialized nurse) [39, 71, 105], public health educational campaigns [23, 47, 78, 99, 110] and more media attention [39, 110] were among the most commonly cited facilitators.”
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 [23]
The Results (Table 4; page unavailable) report that 87% of GPs endorsed readily available support services for referral as an incentive to alcohol intervention, making it one of the most highly endorsed incentives. The paper does not specifically identify better co-operation with specialized services as the facilitator. This citation is attached to that first item, not to the sentence's claims about other professionals, campaigns, or media attention. (LLM, conf=0.82)
Experimental — accuracy not yet measuredFew at-risk drinkers are identified as such and counselled to cut down.
“However, few at-risk drinkers are identified as such and counselled to cut down [17–23].”
The majority of GPs in 14 studies and of nurses in 2 quantitative studies reported the opposite, that they felt skilled enough to deliver alcohol SBI.
“on the other hand, the majority of the GPs in 14 [16, 20, 23, 36, 52, 62, 64, 70, 78, 83, 95, 106, 108, 111], and of the nurses in 2 quantitative studies [36, 70] reported the opposite.”
Several studies on both GPs and nurses reported availability of educational and training programmes as an important facilitator.
“Several studies on both GPs and nurses reported availability of educational and training programmes as an important facilitator [23, 36, 55, 73, 78, 84].”
The majority of GPs in 2 UK and 1 USA study thought that preventing alcohol problems was their responsibility.
“on the other hand, the majority of the GPs in 2 studies from the UK and 1 study from the USA thought the opposite [23, 65, 78].”
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.”
With the exception of 1 study on GPs from Sri Lanka, the majority of GPs in the remaining 13 studies and of nurses in 3 studies reported feeling unsatisfied advising patients to cut down.
“With the notable exception of 1 study on GPs from Sri Lanka [67], the majority of the GPs in the remaining 13 studies addressing this issue (8 from the UK), and of the nurses in 3 studies (2 from Sweden and 1 from the UK) reported feeling unsatisfied advising patients to cut down [16, 20, 23, 44, 57, 59–62, 73, 78, 94, 108].”
The majority of GPs in 8 of 10 quantitative studies felt unmotivated to work with at-risk drinkers.
“The majority of the GPs in 8 from a total of 10 quantitative studies felt unmotivated to work with at-risk drinkers [16, 23, 44, 57, 62, 66, 78, 94, 95, 108].”
Lack of resources included lack of screening tools, counselling materials, and specific guidelines.
“Lack of resources included lack of screening tools [20, 23, 47, 74, 78], counselling materials [20, 23, 42, 47, 78, 109] and specific guidelines [103].”
In 5 survey studies among GPs, 4 found that a majority of GPs did not believe patients would resent being asked about alcohol.
“This issue was addressed in 5 survey studies among GPs, of which 4 found a majority of GPs did not believe patients would resent being asked [20, 23, 47, 56, 78].”
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 [23]
The Results sections on asking about alcohol use and perceived barriers report how often GPs ask and what they see as barriers, but not whether they believe patients would resent being asked. A separate Results passage says most GPs considered it legitimate to ask problem or dependent drinkers about alcohol; that does not establish their expectations of patients’ reactions. Searches for resentment and related terms found no passage addressing the claim. (LLM, conf=0.72)
Experimental — accuracy not yet measuredFourteen to 54% of GPs in 3 quantitative studies considered alcohol an unimportant issue in primary health care.
“Fourteen to 54% of the GPs in 3 quantitative studies considered alcohol an unimportant issue in PHC [23, 47, 78].”
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 [23]
The Results section, “Attitudes to working with different types of drinker” (page unavailable), reports GPs’ views on whether asking about alcohol was legitimate and their motivation to work with drinkers. It does not report how many considered alcohol an unimportant issue in primary health care. Searches for that assessment and the 14–54% range found no supporting passage in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measured
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“Barriers to ASBI delivery behavior reflecting capability, motivation, or opportunity (COM-B) components were identified in the literature (Burgering and Willems 2013; Johnson et al. 2011; Wilson et al. 2011): (1) lack of knowledge (capability), (2) use of personal reference frames to discuss alcohol (capability), (3)…”
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- Authors
- Wilson, G. B., Lock, C. A., Heather, N., Cassidy, P., Christie, M. M., & Kaner, E. F. S.
- Affiliations
- Newcastle University (GB)
- Northumbria University (GB)
- University of Leicester (GB)
- Corresponding author
- Wilson, Graeme B.
- Venue
- Alcohol and Alcoholism
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-06-20
- Volume
- 46
- Issue
- 5
- Pages
- 570-577
- ISSN
- 0735-0414 (ISSN-L)
- 1464-3502
- PMC
- PMC3156887
- OpenAlex
- W2106632751
- Cited by
- 112
- References
- 48
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 3 · 2021: 13 · 2020: 6 · 2019: 3 · 2018: 8 · 2017: 7 · 2016: 13 · 2015: 16 · 2014: 9 · 2013: 10 · 2012: 5
- FWCI
- 6.27
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Alcohol and Alcoholism (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Leicester Research Archive (University of Leicester) (submittedVersion)
- Northumbria Research Link (Northumbria University) (submittedVersion)
- Newcastle University ePrints (Newcastle Univesity) (cc-by-nc)
- Funders
- Economic and Social Research Council (ES/G007470/1)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- excessive alcohol consumption, alcohol-related problems, general practitioners, primary care, screening and brief intervention, alcohol prevention, barriers to intervention, job satisfaction, alcohol policy
- MeSH terms
- Adult, Aged, Alcohol Drinking, Alcoholism, Attitude of Health Personnel, Education, Medical, England, Family Practice, Female, Humans, Job Satisfaction, Male, Middle Aged, Motivation, Primary Health Care, Public Policy, Surveys and Questionnaires, Self Concept, General Practitioners
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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 ›
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