Screening and brief intervention for excessive alcohol use: qualitative interview study of the experiences of general practitioners
Open accessAbstract
OBJECTIVE: To explore the suitability of a screening based intervention for excessive alcohol use by describing the experiences of general practitioners who tried such an intervention in their everyday practice. DESIGN: Qualitative interviews with general practitioners who had participated in a pragmatic study of a combined programme of screening and a brief intervention for excessive alcohol use. Doctors were interviewed either individually or in focus groups. A computer based, descriptive, phenomenological method was used to directly analyse the digitally recorded interviews. SETTING AND PARTICIPANTS: 24 of 39 general practitioners in four Danish counties who volunteered to take part in the pragmatic study were interviewed. RESULTS: The doctors were surprised at how difficult it was to establish rapport with the patients who had a positive result on the screening and to ensure compliance with the intervention. Although the doctors considered the doctor-patient relationship robust enough to sustain targeting of alcohol use, they often failed to follow up on initial interventions, and some expressed a lack of confidence in their ability to counsel patients effectively on lifestyle issues. The doctors questioned the rationale of screening in young drinkers who may grow out of excessive drinking behaviour. The programme needed considerable resources, and it interrupted the natural course of consultations and was inflexible. The doctors could not recommend the screening and brief intervention programme, although they thought it important to counsel their patients on drinking. CONCLUSIONS: Screening for excessive alcohol use created more problems than it solved for the participating doctors. The results underline the value of carrying out pragmatic studies on the suitability of seemingly efficacious healthcare programmes.
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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].”
GPs and nurses reported more training for improving counselling skills and feedback on successful cases as facilitators.
“GPs and nurses reported more training for improving counselling skills [20, 49, 78, 83] and feedback on successful cases [71] as facilitators.”
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];”
More training for improving counselling skills and feedback on successful cases were reported as facilitators.
“More training for improving counselling skills [49, 78] and feedback on successful cases [71] were reported as facilitators.”
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Cites
Phenomenology and Psychological Research
Giorgi, A., & Aanstoos, C. M. (1991) · Medical Entomology and Zoology · Cited by 2,210 · see citing works
Brief interventions for alcohol problems: a review
BIEN, T. H., MILLER, W. R., & TONIGAN, J. S. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb00820.x · Cited by 1,577 · see citing works
(1985) · Medical Entomology and Zoology · Cited by 838 · see citing works
Powell, R. A., & Single, H. M. (1996) · International Journal for Quality in Health Care · doi:10.1093/intqhc/8.5.499 · Cited by 707 · see citing works
Using Computers in Qualitative Research
(1994) · Social Science Computer Review · doi:10.1177/089443939401200221 · Cited by 591 · see citing works
Meta-analysis of Randomized Control Trials Addressing Brief Interventions in Heavy Alcohol Drinkers
Wilk, A. I., Jensen, N. M., & Havighurst, T. C. (1997) · Journal of General Internal Medicine · doi:10.1007/s11606-006-5063-z · Cited by 577 · see citing works
Babor, T. F., & Higgins-Biddle, J. C. (2000) · Addiction · doi:10.1046/j.1360-0443.2000.9556773.x · Cited by 315 · see citing works
Shared understanding of the qualitative research process. Guidelines for the medical researcher
MALTERUD, K. (1993) · Family Practice · doi:10.1093/fampra/10.2.201 · Cited by 278 · see citing works
A meta‐analysis of life course variation in drinking*
Fillmore, K. M., Hartka, E., Johnstone, B. M., Leino, E. V., MOTOYOSHI, M., & Temple, M. T. (1991) · British Journal of Addiction · doi:10.1111/j.1360-0443.1991.tb01702.x · Cited by 188 · see citing works
Fillmore, K. M. (1987) · British Journal of Addiction · doi:10.1111/j.1360-0443.1987.tb01440.x · Cited by 140 · see citing works
Outcome studies of brief alcohol intervention in general practice: the problem of lost subjects
Edwards, A., & Rollnick, S. (1997) · Addiction · doi:10.1046/j.1360-0443.1997.9212169911.x · Cited by 126 · see citing works
Kaner, E., Lock, C. A., McAvoy, B., Heather, N., & Gilvarry, E. A. (1999) · Europe PMC (PubMed Central) · doi:10.25405/ncl.34594905 · Cited by 124 · see citing works
INTERPRETING THE EVIDENCE ON BRIEF INTERVENTIONS FOR EXCESSIVE DRINKERS: THE NEED FOR CAUTION *
Heather, N. (1995) · Alcohol and Alcoholism · doi:10.1093/oxfordjournals.alcalc.a045732 · Cited by 124 · see citing works
A Difficult Business: detecting and managing alcohol problems in general practice
Thom, B., & TÉLLEZ, C. (1986) · British Journal of Addiction · doi:10.1111/j.1360-0443.1986.tb00347.x · Cited by 122 · see citing works
Outcome studies of brief alcohol intervention in general practice: the problem of lost subjects.
Edwards, A., & Rollnick, S. (1997) · PubMed · Cited by 114 · see citing works
Lawlor, D. A., Keen, S., & Neal, R. D. (2000) · PubMed · Cited by 71 · see citing works
From risk factors to health resources in medical practice
Hollnagel, H., & Malterud, K. (2000) · Medicine Health Care and Philosophy · doi:10.1023/a:1026597306628 · Cited by 57 · see citing works
Perspectives on prevention: the views of General Practitioners
Williams, S. J., & Calnan, M. (1994) · Sociology of Health & Illness · doi:10.1111/1467-9566.ep11348775 · Cited by 56 · see citing works
Hansen, L. J. (1999) · Family Practice · doi:10.1093/fampra/16.6.551 · Cited by 24 · see citing works
Brief Alcohol Intervention in Medical Settings:Concerns from the Consulting Room
Rollnick, S., Butler, C., & HODGSON, R. J. (1997) · Addiction Research & Theory · doi:10.3109/16066359709004347 · Cited by 22 · see citing works
EXPLORING YOUNG MEN'S DRINKING USING THE AUDIT QUESTIONNAIRE
Harnett, R. (1999) · Alcohol and Alcoholism · doi:10.1093/alcalc/34.5.672 · Cited by 16 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Saunders JB, Aasland OG. WHO collaborative study on identification and treatment of persons with harmful alcohol consumption. Report on phase 1: developement of a screening instrument. Geneva: World Health Organization, 1987.
Cited by
Sorted by citations
Effectiveness of brief alcohol interventions in primary care populations
Kaner, E. F., Beyer, F. R., Muirhead, C., Campbell, F., Pienaar, E. D., Bertholet, N., Daeppen, J. B., Saunders, J. B., & Burnand, B. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004148.pub4 · Cited by 1,665 · see citing works
Bertholet, N. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.9.986 · Cited by 710 · see citing works
Johnson, M., Jackson, R., Guillaume, L., Meier, P., & Goyder, E. (2011) · Journal of Public Health · doi:10.1093/pubmed/fdq095 · Cited by 374 · see citing works
Online Alcohol Interventions: A Systematic Review
White, A., Kavanagh, D., Stallman, H., Klein, B., Kay-Lambkin, F., Proudfoot, J., Drennan, J., Connor, J., Baker, A., Hines, E., et al. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1479 · Cited by 305 · see citing works
Kypri, K., Saunders, J. B., Williams, S. M., McGee, R. O., Langley, J. D., Cashell‐Smith, M. L., & Gallagher, S. J. (2004) · Addiction · doi:10.1111/j.1360-0443.2004.00847.x · Cited by 287 · see citing works
Agerwala, S. M., & McCance-Katz, E. F. (2012) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2012.720169 · Cited by 258 · see citing works
Ballesteros, J., Duffy, J. C., Querejeta, I., Ariño, J., & González‐Pinto, A. (2004) · Alcoholism: Clinical and Experimental Research · doi:10.1097/01.alc.0000122106.84718.67 · Cited by 251 · see citing works
The effects on mortality of brief interventions for problem drinking: a meta‐analysis
Cuijpers, P., Riper, H., & Lemmers, L. (2004) · Addiction · doi:10.1111/j.1360-0443.2004.00778.x · Cited by 158 · see citing works
Rethinking brief interventions for alcohol in general practice
McCambridge, J., & Saitz, R. (2017) · BMJ · doi:10.1136/bmj.j116 · Cited by 146 · 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
“Beich [49] 2002 Denmark English Focus groups Individual interviews 24 Fair”
BackgroundLinke, S., Murray, E., Butler, C., & Wallace, P. (2007) · Journal of Medical Internet Research · doi:10.2196/jmir.9.2.e10 · Cited by 127 · see citing works
Gaps in the Evidence for Well-Child Care: A Challenge to Our Profession
Moyer, V. A., & Butler, M. (2004) · Pediatrics · doi:10.1542/peds.2004-1076 · Cited by 109 · see citing works
Nygaard, P., & Aasland, O. G. (2011) · Alcohol and Alcoholism · doi:10.1093/alcalc/agq073 · Cited by 77 · see citing works
Handbook of Self-Help Therapies
(2007) · doi:10.4324/9780203935439 · Cited by 77 · see citing works
Translating effective web-based self-help for problem drinking into the real world
Riper, H., Kramer, J., Conijn, B., Smit, F., Schippers, G., & Cuijpers, P. (2009) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2009.00970.x · Cited by 50 · see citing works
Aira, M., Kauhanen, J., Larivaara, P., & Rautio, P. (2004) · Preventive Medicine · doi:10.1016/j.ypmed.2003.11.023 · Cited by 45 · see citing works
Under what circumstances are nurses willing to engage in brief alcohol interventions?
Johansson, K., Åkerlind, I., & Bendtsen, P. (2005) · Addictive Behaviors · doi:10.1016/j.addbeh.2004.09.008 · Cited by 45 · see citing works
General practitioners’ strategies to identify alcohol problems: A focus group study
Lid, T. G., & Malterud, K. (2012) · Scandinavian Journal of Primary Health Care · doi:10.3109/02813432.2012.679229 · Cited by 44 · see citing works
Asking patients about their drinking
Holmqvist, M., Bendtsen, P., Spak, F., Rommelsjö, A., Geirsson, M., & Nilsen, P. (2008) · Addictive Behaviors · doi:10.1016/j.addbeh.2007.09.021 · Cited by 42 · see citing works
Beich, A., Gannik, D., Saelan, H., & Thorsen, T. (2007) · Alcohol and Alcoholism · doi:10.1093/alcalc/agm063 · Cited by 41 · see citing works
Self-citationHanschmidt, F., Manthey, J., Kraus, L., Scafato, E., Gual, A., Grimm, C., & Rehm, J. (2017) · Alcohol and Alcoholism · doi:10.1093/alcalc/agx032 · Cited by 34 · see citing works
Berner, M. M., Harter, M., Kriston, L., Lohmann, M., Ruf, D., Lorenz, G., & Mundle, G. (2007) · Alcohol and Alcoholism · doi:10.1093/alcalc/agm013 · Cited by 35 · see citing works
Johansson, K., Bendtsen, P., & Åkerlind, I. (2005) · Public Health · doi:10.1016/j.puhe.2004.12.006 · Cited by 33 · see citing works
Poplas Susič, T., Kersnik, J., & Kolšek, M. (2010) · Wiener klinische Wochenschrift · doi:10.1007/s00508-010-1335-z · Cited by 25 · see citing works
Staton, C. A., Vissoci, J. R. N., Wojcik, R., Hirshon, J. M., Mvungi, M., Mmbaga, B. T., & Swahn, M. (2018) · Alcohol · doi:10.1016/j.alcohol.2018.01.003 · Cited by 22 · see citing works
Kersnik, J., Susič, T. P., Kolšek, M., & Švab, I. (2009) · Journal of International Medical Research · doi:10.1177/147323000903700534 · Cited by 24 · see citing works
Cowell, A. J., Dowd, W. N., Mills, M. J., Hinde, J. M., & Bray, J. W. (2017) · Addiction · doi:10.1111/add.13650 · Cited by 17 · see citing works
Van Zyl, P., Gagiano, C., Mollentze, W., Snyman, J., & Joubert, G. (2013) · South African Family Practice · doi:10.1080/20786204.2013.10874417 · Cited by 6 · see citing works
- Authors
- Beich, A.
- Affiliations
- University of Copenhagen (DK)
- Corresponding author
- Beich, A.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2002-10-19
- Volume
- 325
- Issue
- 7369
- Pages
- 870-870
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC129636
- OpenAlex
- W2117405519
- Cited by
- 285
- References
- 21
- Citations by year
- 2025: 6 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 11 · 2020: 14 · 2019: 3 · 2018: 10 · 2017: 18 · 2016: 12 · 2015: 19 · 2014: 15 · 2013: 8 · 2012: 26
- FWCI
- 11.81
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- screening and brief intervention, excessive alcohol use, general practitioners, physician experience, physician-patient relationship, patient rapport, intervention adherence, follow-up, lifestyle counseling
- MeSH terms
- Adult, Alcoholism, Denmark, Family Practice, Female, Humans, Male, Mass Screening, Middle Aged, Physician-Patient Relations, Psychotherapy, Brief
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