Brief alcohol intervention as a daily routine. Description of an action research project creating instructions for primary health care
DOI:
https://doi.org/10.20882/adicciones.396Keywords:
Action research, attitudes, brief intervention, risky drinking, primary health, careAbstract
Brief alcohol intervention is poorly taken up by primary health care professionals. The aim of the present study was to see whether and how brief intervention could be done as part of everyday work. The study included a questionnaire to primary care staff, videotaped focus groups of professionals, and a questionnaire to patients in primary health care setting in the City of Tampere, Finland, with about 200 000 inhabitants. The method was qualitative (categorized) analysis of the three sources of information (questionnaire to professionals, questionnaire to patients, focus groups) and discussions by the staffs during the action. Patients’ and professionals’ positive attitudes towards brief intervention provided the ethical ground to create instructions. Nurses and general practitioners wanted short, practical instructions, but felt that it was feasible to do brief intervention only in certain situations, not systematically; they preferred verbal communication to structured questionnaires, and wanted written information for patients and clear instructions when to refer. Based on information and feedback, short instructions were created and accepted by staff. It is possible to find a way for primary health care professionals to do brief alcohol intervention. This may differ in different cultures and should be individually tailored, but the methods used here are globally applicable.References
Aalto M, Pekuri P, Seppä, K. (2001) Primary health care nurses’ and physicians’ attitudes, knowledge and beliefs regarding brief intervention for heavy drinkers. Addiction 96:305-311.
Aalto M, Pekuri P, Seppä K. (2002) Primary health care personnels’ activity in intervening in patients’ alcohol drinking: a patient perspective. Drug and Alcohol Dependence 66 :39-43.
Aalto M, Pekuri P, Seppä, K. (2003) Obstacles to carrying out brief intervention for heavy drinkers in primary health care: a focus group study. Drug and Alcohol Review 22:169-173.
Adams PA, Powell A, McCormick R, Paton-Simpson G. (1997) Incentives for general practitioners to provide brief interventions for alcohol problems. New Zeeland Medical Journal 110:291-294.
Andréasson S, Hjalmarsson K, Rehnman C. (2000) Implementation and dissemination of methods for prevention of alcohol problems in primary health care: a feasibility study. Alcohol & Alcoholism 35:525-30.
Ballesteros J, Duffy J, Querejeta I, Arino J, Gonzalez-Pinto A. (2004) Efficacy of brief interventions for hazardous drinkers in primary care: systematic review and meta-analysis. Alcoholism: Clinical and Experimental Research 28:608-618.
Beich A, Gannik D, Malterud K. (2002) Screening and brief intervention for excessive alcohol use: qualitative inter view study of the experiences of general practitioners. British Medical Journal 325:870-2.
Fleming MF, Mundt MP, French MT, Manwell LB, Stauffacher EA, Barry, KL (2000) Benefit-cost analysis of brief physician advice with problems drinkers in primary care settings. Medical Care 38:7-18.
Fleming MF, Mundt MP, French MT, Manwell LB, Stauffacher EA, Barry, KL. (2002) Brief physician advice with problems drinkers: long-term efficacy and benefitcost analysis. Alcoholism: Clinical and Experimental Research 26:36-43.
Freemantle N. (2000) Implementation strategies. Family Practice 17:Suppl 1 :7-10.
Glanville J, Haines M, Auston, I.(1998) Getting research findings into practice: finding information on clinical effectiveness. British Medical Journal 317:200-203.
Greco PJ, Eisenberg JM. (1993) Changing physicians’ practices. New England Journal of Medicine 329:1271-1274.
Kahan M, Wilson L, Becker L. (1995) Effectiveness of physician-based interventions with problem drinkers: a review. Canadian Medical Association Journal 152:851-9.
Kaner EFS. Heather N, McAvoy BR, Lock CA, Gilvarry E. (1999) Intervention for excessive alcohol consumption in primary health care: attitudes and practices of English general practitioners. Alcohol & Alcoholism 34:559-566.
Kaner EF, Heather N, Brodie J, Lock CA, McAvoy BR. (2001) Patient and practitioner characteristics predict brief alcohol intervention in primary care. British Journal of General Practice 51:822-827.
Kääriäinen J, Sillanaukee P, Poutanen, Seppä, K. (2001) Opinions on alcohol-related issues among professionals in primary, occupational, and specialized health care. Alcohol & Alcoholism 36:141-146.
McDuffy DR, Tommasello AC, Hoffman KJ, Johanson JL. (1995) Addictions training for physicians and other licensed health care professionals in Maryland. Maryland Medical Journal 44:453-459.
Moyer A, Finney JW, Swearingen CE, Vergun P. (2002) Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations. Addiction 97:279-292.
Roche AM, Parle MD, Cambell J, Saunders JB. (1995) Substance abuse disorders: psychiatric trainees’ knowledge, diagnostic skills and attitudes. Australian and New Zeeland Journal of Psychiatry 29:645-652.
Roche AM, Freeman T. (2004) Brief interventions: good in theory but weak in practice. Drug and Alcohol Review 23:11-18.
Salaspuro M. Intervention mot riskfylld alkoholkonsumption – sekundär prevention av alkoholproblem. In Berglund M, Andréasson S, Franck J, Fridell M, Håkanson I, Johansson B-A et al, editors. (2001) Behandling av alcohol- och narkotikaproblem. The Swedish Council on Technology Assessment in Health Care. 1st ed, Stockholm, Vol I 31-80.
Saunders JB, Aasland, O.G. (1987) WHO Collaborative Project on the Identification and Treatment of Persons with Harmful Alcohol Consumption. Report on Phase I: Development of a Screening Instrument. Geneva: World Health Organization.
Weller DP, Litt JCP, Pols RG, Ali RL, Southgate DO, Harris RD. (1992) Drug and alcohol related health problems in primary care - what do GPs think? Medical Journal of Australia 156:43-48.
Wilk AI, Jensen NM, Havighurst TC.(1997) Meta-analysis of randomized control trials addressing brief interventions in heavy alcohol drinkers. Journal of General Internal Medicine 12:274-83.
