General practitioners' strategies to identify alcohol problems: a focus group study.
OBJECTIVE
To explore general practitioners' (GPs') experiences with addressing alcohol in the consultation without prior invitation from the patient.


METHODS
Two focus group interviews were conducted with a purposive sample of 13 Norwegian GPs in the Stavanger region. Participants were invited to talk about situations where the doctor initiated discussion of alcohol. Systematic text condensation was applied for analysis.


RESULTS
Participants presented a broad range of examples of what made GPs initiate discussion of alcohol, how they brought up the subject, and what happened when they did so. Sometimes they were just acting on a hunch. Family members were also occasionally prompting the doctor to act, or recent serious incidents worked as cues for asking. Routinely taking or creating an opportunity to explore was also common. Directly confronting the patient was a challenging task, and the participants disclosed experiences of how this had been achieved.


CONCLUSIONS
Pragmatic case-finding appears to be a field of competence which can be further developed, but should be adapted to the clinical setting and the GP's personal style. It is suggested that strategies for dealing with alcohol problems in general practice should be based on a proper understanding of this specific medical context, and be adaptable to different clinical situations and the individual patient.
Research Unit for General Practice, Uni Health, Bergen, Norway. giljelid@gmail.com
Torgeir Gilje
TG
Lid
Kirsti
K
Malterud
D000293:Adolescent; D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis*; D000437:Alcoholism / Q000175:diagnosis*; D001291:Attitude of Health Personnel; D005194:Family Practice / Q000379:methods; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000379:methods*; D008875:Middle Aged; D009664:Norway; D055815:Young Adult