title: Addressing patient alcohol use: a view from general practice.
abstract: BACKGROUND
  General practitioners (GPs) have the potential to promote alcohol harm minimisation via discussion of alcohol use with patients, but knowledge of GPs' current practice and attitudes on this matter is limited. Our aim was to assess GPs' current practice and attitudes towards discussing alcohol use with their patients.
  
  
  METHODS
  This qualitative study involved semi-structured, face-to-face interviews with 19 GPs by a group of medical students in primary care practices in Wellington, New Zealand.
  
  
  RESULTS
  Despite agreement amongst GPs about the importance of their role in alcohol harm minimisation, alcohol was not often raised in patient consultations. GPs' usual practice included referral to drug and alcohol services and advice. GPs were also aware of national drinking guidelines and alcohol screening tools, but in practice these were rarely utilised. Key barriers to discussing alcohol use included its societal 'taboo' nature, time constraints, and perceptions of patient dishonesty.
  
  
  CONCLUSIONS
  In this study there is a fundamental mismatch between the health community's expectations of GPs to discuss alcohol with patients and the reality. Potential solutions to the most commonly identified barriers include screening outside the GP consultation, incorporating screening tools into existing software used by GPs, exploring with GPs the social stigma associated with alcohol misuse, and framing alcohol misuse as a health issue. As it is unclear if these approaches will change GP practice, there remains scope for the development and pilot testing of potential solutions identified in this research, together with an assessment of their efficacy in reducing hazardous alcohol consumption.
authors.affiliation: Department of Public Health, University of Otago, Wellington, New Zealand.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mules
authors.forename: Jennifer
authors.initials: J
authors.lastname: Taylor
authors.forename: Rachel
authors.initials: R
authors.lastname: Price
authors.forename: Logan
authors.initials: L
authors.lastname: Walker
authors.forename: Baneet
authors.initials: B
authors.lastname: Singh
authors.forename: Patrick
authors.initials: P
authors.lastname: Newsam
authors.forename: Thenmoli
authors.initials: T
authors.lastname: Palaniyappan
authors.forename: Toby
authors.initials: T
authors.lastname: Snook
authors.forename: Mahfuzah
authors.initials: M
authors.lastname: Ruselan
authors.forename: John
authors.initials: J
authors.lastname: Ryan
authors.forename: Jaishree
authors.initials: J
authors.lastname: Santhirasegaran
authors.forename: Phoebe
authors.initials: P
authors.lastname: Shearman
authors.forename: Petronella
authors.initials: P
authors.lastname: Watson
authors.forename: Richard
authors.initials: R
authors.lastname: Zino
authors.forename: Louise
authors.initials: L
authors.lastname: Signal
authors.forename: Geoff
authors.initials: G
authors.lastname: Fougere
authors.forename: Helen
authors.initials: H
authors.lastname: Moriarty
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Jenkin
mesh_terms: D000437:Alcoholism / Q000517:prevention & control*; D001291:Attitude of Health Personnel; D005260:Female; D058006:General Practice / Q000379:methods; D058005:General Practitioners / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'