Home > Detecting problem alcohol use in Irish general practice.

Millar, Sean (2018) Detecting problem alcohol use in Irish general practice. Drugnet Ireland , Issue 66, Summer 2018 , p. 15.

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A recent report from the World Health Organization (WHO) demonstrated that almost one-half of Irish drinkers engage in heavy drinking on a regular basis, placing Ireland’s binge drinking rates at the second highest of 174 countries studied.1 In addition, per capita alcohol consumption in Ireland has trebled over the past four decades,2 an increase that has been associated with an earlier age at commencing drinking, with research indicating a rise in alcohol use among students in Ireland and increasing levels of high-risk drinking.3 Policymakers have attempted to combat this problem, as tailoring effective public health policy is crucial in tackling this burgeoning issue. Nevertheless, successive legislation has so far been largely ineffective in addressing the alcohol crisis in Ireland.

 

It is recognised that general practitioners (GPs) commonly see patients with a range of alcohol-related risks and problems. GPs have thus been identified as appropriate professionals to screen for those at risk of problem alcohol use and to conduct brief interventions to influence patients to think more actively about their alcohol consumption. Nevertheless, despite the magnitude of the national alcohol problem and the detrimental effects on health and society, there is a surprising lack of data from general practice in Ireland on the documentation of alcohol use and treatment.

 

Recent research aimed to investigate the prevalence of documentation of problem alcohol use in patient records in Irish general practice and to describe the documentation of its diagnosis and treatment.4 In this study, published in the BMC journal Family Practice, GPs affiliated with the Graduate Entry Medical School of the University of Limerick were invited to participate in the study. Seventy-one per cent of the practices participated. One hundred patients were randomly selected from each participating practice and the clinical records were reviewed for evidence of problem alcohol use. Evidence included text in consultation notes; evidence of a pharmacological treatment or psychological intervention by the GP; evidence of a referral to another primary healthcare professional or specialist agencies, and/or diagnostic coding.

 

Key findings from the study included the following: 

  • Only 57 patients (1.5%, 95% CI: 1–2%) were identified as having problem alcohol use in the previous two years.
  • Of the 40 participating practices, 14 (35%) had no patients in their sample with documented problem alcohol use.
  • Patients with problem alcohol use were more likely to be male than those without any problem alcohol use documented (65% vs 47%, p=0.007).
  • 23 patients (0.6%, 95% CI: 0.4–0.9%) were identified as having substance use other than alcohol documented in the previous two years.
  • 29 (51%) of those with documented problem alcohol use were referred to other specialist services; 28 (49%) received a psychological intervention, mostly counselling or a brief intervention. 

As this is the first large-scale study of patient records in general practice in Ireland looking at documentation of screening and treatment of problem alcohol use, the study authors highlight the current lack of documentation of alcohol problems and the need to reinforce positive attitudes among GPs in relation to preventive work.

 

1 WHO (2014) Global status report on alcohol and health, 2014. Geneva: World Health Organization. https://www.drugsandalcohol.ie/21884/

2 OECD (2014) Health statistics. Paris: Organisation for Economic Co-operation and Development.

3 Davoren MP, Shiely F, Byrne M and Perry IJ (2015) Hazardous alcohol consumption among university students in Ireland: a cross-sectional study, BMJ Open, 5(1): e006045. https://www.drugsandalcohol.ie/23350/

4 O’Regan A, Cullen W, Hickey L, Meagher D and Hannigan A (2018) Is problem alcohol use being detected and treated in Irish general practice?, BMC Family Practice, 19: 30. https://www.drugsandalcohol.ie/28595/

Item Type:Article
Issue Title:Issue 66, Summer 2018
Date:September 2018
Page Range:p. 15
Publisher:Health Research Board
Volume:Issue 66, Summer 2018
EndNote:View
Subjects:A Substance use, abuse, and dependence > Prevalence > Substance use behaviour > Alcohol consumption
B Substances > Alcohol
G Health and disease > Substance use disorder > Alcohol use > Alcohol dependence
HA Screening, identification, and diagnostic method > Medical screening and diagnostic method
J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for substance use
J Health care, prevention and rehabilitation > Patient care management
J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)
T Demographic characteristics > Doctor
VA Geographic area > Europe > Ireland

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