Factors influencing GPs' decisions regarding screening for high alcohol consumption: a focus group study in Swedish primary care.
OBJECTIVE
The aim of this study was to explore factors that influence general practitioners' (GPs') decisions regarding screening for high alcohol consumption.


METHODS
GPs working at three primary healthcare centres in Sweden participated in focus group interviews. The interviews were recorded and transcribed verbatim, and a deductive framework approach was used for the analysis.


RESULTS
The majority of the participating GPs did not believe in asking all patients about their alcohol consumption. Reported factors that influenced how many and which patients were questioned about alcohol consumption were time, age of the patient, consultation setting, patient-physician relationship, what symptoms the patient presented with, and knowledge of measures if patients appear to have a high alcohol consumption. Thus, alcohol screening and intervention were not performed in all patient groups as was originally intended, but were performed in limited groups of patients such as those with alcohol-related symptoms.


CONCLUSIONS
Although the number of participants in this study was small and the conclusions cannot be generalized, the results provide some valuable insights into why GPs are hesitant to engage in screening for high alcohol consumption. Since prevention of alcohol-related health problems is an important public health issue, many different screening and intervention strategies have to be formulated and evaluated in order to reach patients with both hazardous and harmful alcohol consumption within the healthcare system. Screening all consecutive patients for a limited period or screening patient groups known to include a fairly high frequency of high alcohol consumers are two ways of limiting the time requirements and increasing role legitimacy. Still, there is a need for a broader public health strategy involving many players in the community in alcohol preventive measures, especially in more primary preventive approaches.
Johansson
K
K
Department of Health and Society, Social Medicine and Public Health Science, Linköping University, S-581 83 Linköping, Sweden. kjell.johansson@lio.se
Bendtsen
P
P
Akerlind
I
I
D000428:Alcohol Drinking; D000437:Alcoholism / Q000150:complications / Q000175:diagnosis*; D001291:Attitude of Health Personnel; D003376:Counseling; D003657:Decision Making; D003955:Diagnostic Tests, Routine; D017144:Focus Groups; D006801:Humans; D008487:Medical History Taking; D010817:Physician-Patient Relations; D010821:Physicians, Family / Q000193:education / Q000523:psychology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods; D013548:Sweden