Why don't we detect-at-risk drinkers? A qualitative study of general practitioner beliefs and attitudes
Background
|
AUDIT-C
(1998)
|
AUDIT
(1989)
Aim
Discussion
17-19 October 2013
GP13 Conference, Darwin
Michael Tam
Lecturer in Primary Care
University of New South Wales
m.tam@unsw.edu.au
Nicholas Zwar
Professor of General Practice
University of New South Wales
Roslyn Markham
Postgraduate Research Coordinator
New South Wales Institute of Psychiatry
Results
Method
diagrams
tree
maps
CAGE
(1970)
"Responsibility for the failure of early diagnosis and treatment of alcohol misuse in medical settings lies neither with the patient or physician but with the relationship of their roles."
- Murphy HB.
J Stud Alcohol 1980; 41(5): 417-428
impact of social and
cultural attitudes
"It's socially unacceptable to say you're a heavy drinking, but it's actually socially acceptable to be a heavy drinker. That's the problem..." (D11)
dynamics of patient-
doctor interactions
"... And someone with a cold, unless they're a new patient... it wouldn't be something that you'd necessarily ask about... And they might be a bit affronted if you did, if you couldn't figure a way of bringing it in." (D6)
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HREA
20
19
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Focus groups of
Sydney GPs
Describe
GP beliefs and
attitudes on
detecting at-
risk drinking
detecting at-risk
drinking is important
but difficult to do
"...I think people are extraordinarily resourceful in the ways in which they're able to potentially cover up behaviour they don't want others to see. So, people are likely to under-report the amount that they're drinking, either knowingly or subconsciously..." (D18)
et al.
Rydon
(1992)
|
coding of data
theoretical sampling
constant comparison in
analysis
development of theory
"... it's [detecting] a lot of people that probably are not really having a problem... it seems silly..." (D17)
alcohol screening
questionnaires lack
practical utility
et al.
Reid
(1986)
|
et al.
Berner
(2007)
|
detecting at-risk
drinking is important
but difficult to do
impact of social and
cultural attitudes
dynamics of patient-
doctor interactions
alcohol screening
questionnaires lack
practical utility
1 in 3
Understand
Low uptake
of screening
questionnaires