Skip to main content
NCBI home page
Canadian Family Physician logoLink to Canadian Family Physician
. 1994 Sep;40:1557–1566.

Detecting, preventing, and managing patients' alcohol problems.

B Rush 1, M Bass 1, M Stewart 1, E McCracken 1, M Labreque 1, S Bondy 1
PMCID: PMC2380275  PMID: 7920049

Abstract

OBJECTIVE: To examine Canadian family physicians' attitudes, beliefs, and practices regarding alcohol use and alcohol-related problems among their patients. DESIGN: A self-administered questionnaire mailed to a random sample of 2883 family physicians. The survey was conducted using a modified Dillman method. PARTICIPANTS: Canadian physicians in active office-based practice during 1989. Sample included certificated and noncertificated members of the College of Family Physicians of Canada, as well as non-members of the College. MAIN OUTCOME MEASURES: Perceived importance of various health-promotion behaviours; attitudes and beliefs about working with problem drinkers; current knowledge and practices regarding identifying and managing problem drinkers; and demographic characteristics. RESULTS: Respondents had a strong sense of role legitimacy in working with problem drinkers, but predominantly negative and pessimistic attitudes. Half the respondents felt they had failed in their work with problem drinkers. More physicians agreed on a psychosocial etiology for alcoholism than on a biological origin. Three quarters of respondents said they "almost always" ask patients about quantity and frequency of alcohol use, and just over one third "almost always" ask about problems related to drinking. Data also suggest doctors have relatively few patients with alcohol problems, and they need help in responding to such patients. CONCLUSION: Physicians need more training for their role in identifying and managing patients with alcohol problems.

Full text

PDF
1557

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson P., Clement S. The AAPPQ revisited: the measurement of general practitioners' attitudes to alcohol problems. Br J Addict. 1987 Jul;82(7):753–759. doi: 10.1111/j.1360-0443.1987.tb01542.x. [DOI] [PubMed] [Google Scholar]
  2. Anderson P. Managing alcohol problems in general practice. Br Med J (Clin Res Ed) 1985 Jun 22;290(6485):1873–1875. doi: 10.1136/bmj.290.6485.1873. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Babor T. F., Ritson E. B., Hodgson R. J. Alcohol-related problems in the primary health care setting: a review of early intervention strategies. Br J Addict. 1986 Feb;81(1):23–46. doi: 10.1111/j.1360-0443.1986.tb00291.x. [DOI] [PubMed] [Google Scholar]
  4. Bouchier-Hayes T. A., Jones C. W. The treatment of sports injuries: a comparison between naproxen and indomethacin. A Royal Army Medical Corps multicentre study. Practitioner. 1979 Nov;223(1337):706–710. [PubMed] [Google Scholar]
  5. Brewster J. M., Single E., Ashley M. J., Chow Y. C., Skinner H. A., Rankin J. G. Preventing alcohol problems: survey of Canadian medical schools. CMAJ. 1990 Nov 15;143(10):1076–1082. [PMC free article] [PubMed] [Google Scholar]
  6. Bush B., Shaw S., Cleary P., Delbanco T. L., Aronson M. D. Screening for alcohol abuse using the CAGE questionnaire. Am J Med. 1987 Feb;82(2):231–235. doi: 10.1016/0002-9343(87)90061-1. [DOI] [PubMed] [Google Scholar]
  7. Clement S. The identification of alcohol-related problems by general practitioners. Br J Addict. 1986 Apr;81(2):257–264. doi: 10.1111/j.1360-0443.1986.tb00325.x. [DOI] [PubMed] [Google Scholar]
  8. Kristenson H., Ohlin H., Hultén-Nosslin M. B., Trell E., Hood B. Identification and intervention of heavy drinking in middle-aged men: results and follow-up of 24-60 months of long-term study with randomized controls. Alcohol Clin Exp Res. 1983 Spring;7(2):203–209. doi: 10.1111/j.1530-0277.1983.tb05441.x. [DOI] [PubMed] [Google Scholar]
  9. Mayfield D., McLeod G., Hall P. The CAGE questionnaire: validation of a new alcoholism screening instrument. Am J Psychiatry. 1974 Oct;131(10):1121–1123. doi: 10.1176/ajp.131.10.1121. [DOI] [PubMed] [Google Scholar]
  10. Roche A. M., Guray C., Saunders J. B. General practitioners' experiences of patients with drug and alcohol problems. Br J Addict. 1991 Mar;86(3):263–275. doi: 10.1111/j.1360-0443.1991.tb01779.x. [DOI] [PubMed] [Google Scholar]
  11. Rush B., Ellis K., Crowe T., Powell L. How general practitioners view alcohol use. Clearing up the confusion. Can Fam Physician. 1994 Sep;40:1570–1579. [PMC free article] [PubMed] [Google Scholar]
  12. Saunders J. B., Conigrave K. M. Early identification of alcohol problems. CMAJ. 1990 Nov 15;143(10):1060–1069. [PMC free article] [PubMed] [Google Scholar]
  13. Schoen R. T., Vender R. J. Mechanisms of nonsteroidal anti-inflammatory drug-induced gastric damage. Am J Med. 1989 Apr;86(4):449–458. doi: 10.1016/0002-9343(89)90344-6. [DOI] [PubMed] [Google Scholar]
  14. Skinner H. A., Holt S., Schuller R., Roy J., Israel Y. Identification of alcohol abuse using laboratory tests and a history of trauma. Ann Intern Med. 1984 Dec;101(6):847–851. doi: 10.7326/0003-4819-101-6-847. [DOI] [PubMed] [Google Scholar]
  15. Skinner H. A., Holt S., Sheu W. J., Israel Y. Clinical versus laboratory detection of alcohol abuse: the alcohol clinical index. Br Med J (Clin Res Ed) 1986 Jun 28;292(6537):1703–1708. doi: 10.1136/bmj.292.6537.1703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Smith H. E., Herbert C. P. Preventive practice among primary care physicians in British Columbia: relation to recommendations of the Canadian Task Force on the Periodic Health Examination. CMAJ. 1993 Dec 15;149(12):1795–1800. [PMC free article] [PubMed] [Google Scholar]
  17. Thom B., Téllez C. A difficult business: detecting and managing alcohol problems in general practice. Br J Addict. 1986 Jun;81(3):405–418. doi: 10.1111/j.1360-0443.1986.tb00347.x. [DOI] [PubMed] [Google Scholar]
  18. Vetter G. A comparison of naproxen and diclofenac sodium in the treatment of osteoarthritis in elderly patients. Br J Clin Pract. 1985 Jul;39(7):276–281. [PubMed] [Google Scholar]
  19. Wallace P., Cutler S., Haines A. Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption. BMJ. 1988 Sep 10;297(6649):663–668. doi: 10.1136/bmj.297.6649.663. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Wechsler H., Levine S., Idelson R. K., Rohman M., Taylor J. O. The physician's role in health promotion--a survey of primary-care practitioners. N Engl J Med. 1983 Jan 13;308(2):97–100. doi: 10.1056/NEJM198301133080211. [DOI] [PubMed] [Google Scholar]
  21. Weller D. P., Litt J. C., Pols R. G., Ali R. L., Southgate D. O., Harris R. D. Drug and alcohol related health problems in primary care--what do GPs think? Med J Aust. 1992 Jan 6;156(1):43–48. [PubMed] [Google Scholar]
  22. Williams J. G., Engler C. A double-glind comparative trial of naproxen and indomethacin in sports injuries. Rheumatol Rehabil. 1977 Nov;16(4):265–269. doi: 10.1093/rheumatology/16.4.265. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

RESOURCES