title: Gambling problems among patients in primary care: a cross-sectional study of general practices.
abstract: BACKGROUND
  Primary care is an important context for addressing health-related behaviours, and may provide a setting for identification of gambling problems.
  
  
  OBJECTIVE
  To indicate the extent of gambling problems among patients attending general practices, and explore settings or patient groups that experience heightened vulnerability.
  
  
  METHODS
  Cross-sectional study of patients attending 11 general practices in Bristol, South West England.
  
  
  METHODS
  Adult patients (n= 1058) were recruited from waiting rooms of practices that were sampled on the basis of population characteristics. Patients completed anonymous questionnaires comprising measures of mental health problems (for example, depression) and addictive behaviours (for example, risky alcohol use). The Problem Gambling Severity Index (PGSI) measured gambling problems, along with a single-item measure of gambling problems among family members. Estimates of extent and variability according to practice and patient characteristics were produced.
  
  
  RESULTS
  There were 0.9% of all patients exhibiting problem gambling (PGSI ≥5), and 4.3% reporting problems that were low to moderate in severity (PGSI 1-4). Around 7% of patients reported gambling problems among family members. Further analyses indicated that rates of any gambling problems (PGSI ≥1) were higher among males and young adults, and more tentatively, within a student healthcare setting. They were also elevated among patients exhibiting drug use, risky alcohol use, and depression.
  
  
  CONCLUSIONS
  There is need for improved understanding of the burden of, and responses to, patients with gambling problems in general practices, and new strategies to increase identification to facilitate improved care and early intervention.
authors.affiliation: Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK; visiting fellow, Centre for Gambling Research, ANU Centre for Social Research and Methods, Research School of Social Sciences, Australian National University (ANU), Canberra, Australia.
authors.forename: Sean
authors.initials: S
authors.lastname: Cowlishaw
authors.affiliation: Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Lone
authors.initials: L
authors.lastname: Gale
authors.affiliation: Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Gregory
authors.affiliation: Professor of Addictive Behaviours and Public Health, Department of Health Sciences, University of York, York0, UK.
authors.forename: Jim
authors.initials: J
authors.lastname: McCambridge
authors.affiliation: Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: David
authors.initials: D
authors.lastname: Kessler
mesh_terms: D001291:Attitude of Health Personnel; D016739:Behavior, Addictive / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D004739:England; D005715:Gambling / Q000175:diagnosis* / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation; D058006:General Practice; D006801:Humans; D008019:Life Style; D011315:Preventive Medicine; D011320:Primary Health Care; D012309:Risk-Taking; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: England; cross-sectional study; gambling; general practice