title: Intervention against excessive alcohol consumption in primary health care: a survey of GPs' attitudes and practices in England 10 years on.
abstract: OBJECTIVE
  To ascertain the views of general practitioners (GPs) regarding the prevention and management of alcohol-related problems in practice, together with perceived barriers and incentives for this work; to compare our findings with a comparable survey conducted 10 years earlier.
  
  
  METHODS
  In total, 282 (73%) of 419 GPs surveyed in East Midlands, UK, completed a postal questionnaire, measuring practices and attitudes, including the Shortened Alcohol and Alcohol Problems Perception Questionnaire (SAAPPQ).
  
  
  RESULTS
  GPs reported lower levels of post-graduate education or training on alcohol-related issues (<4 h for the majority) than in 1999 but not significantly so (P = 0.031). In the last year, GPs had most commonly requested more than 12 blood tests and managed 1-6 patients for alcohol. Reports of these preventive practices were significantly increased from 1999 (P < 0.001). Most felt that problem or dependent drinkers' alcohol issues could be legitimately (88%, 87%) and adequately (78%, 69%) addressed by GPs. However, they had low levels of motivation (42%, 35%), task-related self-esteem (53%, 49%) and job satisfaction (15%, 12%) for this. Busyness (63%) and lack of training (57%) or contractual incentives (48%) were key barriers. Endorsement for government policies on alcohol was very low.
  
  
  CONCLUSIONS
  Among GPs, there still appears to be a gap between actual practice and potential for preventive work relating to alcohol problems; they report little specific training and a lack of support. Translational work on understanding the evidence-base supporting screening and brief intervention could incentivize intervention against excessive drinking and embedding it into everyday primary care practice.
authors.affiliation: Institute of Health and Society, Newcastle University, Baddiley Clark Building, Richardson Road, Newcastle Upon Tyne NE2 4AX, UK. g.b.wilson@ncl.ac.uk
authors.forename: Graeme B
authors.initials: GB
authors.lastname: Wilson
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Lock
authors.forename: Nick
authors.initials: N
authors.lastname: Heather
authors.forename: Paul
authors.initials: P
authors.lastname: Cassidy
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Christie
authors.forename: Eileen F S
authors.initials: EF
authors.lastname: Kaner
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000517:prevention & control* / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis / Q000517:prevention & control*; D001291:Attitude of Health Personnel; D004501:Education, Medical; D004739:England; D005194:Family Practice; D005260:Female; D058005:General Practitioners; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011320:Primary Health Care; D011640:Public Policy; D012649:Self Concept; D011795:Surveys and Questionnaires