Alcohol and Alcoholism Advance Access originally published online on May 17, 2007
Alcohol and Alcoholism 2007 42(4):308-316; doi:10.1093/alcalc/agm013
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Detection and management of alcohol use disorders in German primary care influenced by non-clinical factors
1 University Medical Center Freiburg, Department of Psychiatry and Psychotherapy, Hauptstr. 5, D-79104 Freiburg, Germany
2 University Medical Center Tübingen, Hospital for Psychiatry and Psychotherapy, Osianderstr. 22, D-72076 Tübingen, Germany
3 University Medical Center Tübingen, Department of General Medicine, Keplerstr. 15, D-72074 Tübingen, Germany
* Author to whom correspondence should be addressed at: Dr. Michael M. Berner, Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstr. 5, D-79104 Freiburg, Germany. Tel: +49 761/270-6974; Fax: +49 761/270-6989; E-mail: michael.berner{at}uniklinik-freiburg.de
Received 13 November 2006; first review notified 14 December 2006; in revised form 15 December 2006; accepted 26 February 2007
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Abstract |
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Aims: The primary objective was to assess the proportion of detected and correctly referred patients in German primary care. The secondary objective was to identify patient and practitioner characteristics that predict detection and correct referral. \AbsHI{Methods} In this clustered cross-sectional survey in German primary care, 3003 patients were consecutively invited to participate, and were asked to fill in a standardized health questionnaire. They were then screened for problematic alcohol consumption using the Alcohol Use Disorders Identification Test. The physicians recorded their assessment of the presence of any alcohol use disorder and documented the treatment course of all identified patients for 3 months. Results Correctly identified problem drinkers were 38.6% in a per-protocol analysis and 33.6% using a worst-case scenario. Referral behaviour of physicians was in conformity with current practice guidelines in 64.6% of the documented cases and 27.0% in a worst-case scenario. Several patient (e.g. sex, age) and practitioner characteristics (e.g. age), which influence the diagnosis and referral of patients, could be identified. Conclusions There is a clear need to increase the special diagnostic and therapeutic skills of general practitioners so that they may be able to indicate and perform secondary prevention. Further research should focus on the likely effects of the implementation of these diagnostic and management tools.
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