Home > Problem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatment.

Field, Catherine-Anne and Klimas, Jan and Barry, Joseph and Bury, Gerard and Keenan, Eamon and Smyth, Bobby P and Cullen, Walter (2013) Problem alcohol use among problem drug users in primary care: a qualitative study of what patients think about screening and treatment. BMC Family Practice , 14 , p. 98.

URL: http://www.biomedcentral.com/1471-2296/14/98/

Background:
Problem alcohol use is common and associated with considerable adverse outcomes among patients who attend primary care in Ireland and other European countries for opiate substitution treatment. This paper aims to describe patients’ experience of, and attitude towards, screening and therapeutic interventions for problem alcohol use in primary care.

Methods:
This qualitative study recruited problem drug users (N = 28) from primary care based methadone programmes in the Ireland’s Eastern region, using a stratified sampling matrix to include size of general practice and geographical area. Semi-structured interviews were conducted and analysed using thematic analysis, and audited by a third reviewer.

Results:
We identified three overarching themes relevant to the purpose of this paper: (1) patients’ experience of, and (2) attitude towards, screening and treatment for problem alcohol use in primary care, as well as their (3) views on service improvement. While most patients reported being screened for problem alcohol use at initial assessment, few recalled routine screening or treatment. Among the barriers and enablers to screening and treatment, patients highlighted the importance of the practitioner-patient relationship in helping them address the issue. Nevertheless, patients felt that healthcare professionals should be more proactive in the management of problem alcohol use at a primary care level and that primary care can play an important role in their treatment.

Conclusions:
Problem alcohol use is an important challenge in the care of problem drug users. While primary care is well placed to address this issue, little data has reported on this topic. The development of interventions which promote screening and brief interventions in practice are likely to benefit this at-risk group and further research and education, that help achieve this goal, are a priority. Strategies such as dissemination of clinical guidelines, educational videos, academic detailing and practice visits, should be explored.


Item Type:Article
Date:July 2013
Page Range:p. 98
Publisher:BioMed Central
Volume:14
EndNote:View
Accession Number:HRB (Electronic Only)
Subjects:VA Geographic area > Europe > Ireland
J Health care, prevention and rehabilitation > Treatment and maintenance > Patient attitude toward treatment
J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for substance use
B Substances > Alcohol
A Substance use, abuse, and dependence > Prevalence > Substance use behaviour > Alcohol consumption
G Health and disease > Substance use disorder > Multiple substance use (Poly-drug /Poly-substance)
HA Screening, identification, and diagnostic method > Medical screening and diagnostic method
G Health and disease > Substance use disorder > Alcohol use > Alcohol dependence
J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)

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