title: How Australian general practitioners engage in discussions about alcohol with their patients: a cross-sectional study.
abstract: This study aimed to investigate factors that inhibit and facilitate discussion about alcohol between general practitioners (GPs) and patients.
  
  
  
  Data analysis from a cross-sectional survey.
  
  
  
  894 GP delegates of a national health seminar series held in five capital cities of Australia in 2014.
  
  
  
  Likelihood of routine alcohol enquiry; self-assessed confidence in assessing and managing alcohol issues in primary healthcare.
  
  
  
  Most GPs (87%) reported that they were likely to routinely ask patients about their alcohol consumption and had sufficient skills to manage alcohol issues (74%). Potential barriers to enquiring about alcohol included perceptions that patients are not always honest about alcohol intake (84%) and communication difficulties (44%). 'I usually ask about alcohol' was ranked by 36% as the number one presentation likely to prompt alcohol discussion. Altered liver function test results followed by suspected clinical depression were most frequently ranked in the top three presentations. Suspicious or frequent injuries, frequent requests for sickness certificates and long-term unemployment were ranked in the top three presentations by 20% or less. Confidence in managing alcohol issues independently predicted likelihood to 'routinely ask' about alcohol consumption. Lack of time emerged as the single most important barrier to routinely asking about alcohol. Lack of time was predicted by perceptions of competing health issues in patients, fear of eliciting negative responses and lower confidence in ability to manage alcohol-related issues.
  
  
  
  Improving GPs' confidence and ability to identify, assess and manage at-risk drinking through relevant education may facilitate greater uptake of alcohol-related enquiries in general practice settings. Routine establishment of brief alcohol assessments might improve confidence in managing alcohol issues, reduce the time burden in risk assessment, decrease potential stigma associated with raising alcohol issues and reduce the potential for negative responses from patients.
authors.affiliation: Department of Public Health, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Emma R
authors.identifier: 0000-0002-6373-5720
authors.initials: ER
authors.lastname: Miller
authors.affiliation: Department of Public Health, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Imogen J
authors.initials: IJ
authors.lastname: Ramsey
authors.affiliation: Department of Public Health, Flinders University, Adelaide, South Australia, Australia.
authors.forename: Ly Thi
authors.initials: LT
authors.lastname: Tran
authors.affiliation: Department of Public Health, Flinders University, Adelaide, South Australia, Australia.
authors.forename: George
authors.initials: G
authors.lastname: Tsourtos
authors.affiliation: University of Southern Queensland, Toowoomba, Queensland, Australia.
authors.forename: Genevieve
authors.initials: G
authors.lastname: Baratiny
authors.affiliation: University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Manocha
authors.affiliation: Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: Ian N
authors.initials: IN
authors.lastname: Olver
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000628:therapy; D000437:Alcoholism / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D001315:Australia; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice / Q000379:methods*; D058005:General Practitioners / Q000523:psychology*; D006801:Humans; D008107:Liver Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010465:Perception; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000379:methods*; D020377:Self Efficacy; D018582:Sick Leave; D011795:Surveys and Questionnaires; D013997:Time Factors; D014342:Truth Disclosure; D014478:Unemployment; D014947:Wounds and Injuries / Q000209:etiology
keywords: PREVENTIVE MEDICINE; PRIMARY CARE