TY - JOUR
T1 - Still a difficult business? Negotiating alcohol-related problems in general practice consultations
AU - Rapley, Tim
AU - May, Carl
AU - Frances Kaner, Eileen
N1 - Funding Information:
Participants in this study must of necessity remain anonymous, but we thank them for their time and candour. We thank the two reviewers for their generous comments. We acknowledge the financial support of the Alcohol and Education Research Council (APP 41/2001). The AERC are a charity and a research council. We thank Cheryl Wiscombe for her secretarial support for this study. C. May's contribution to this study was partly supported by an ESRC personal research fellowship (RES 000 27 0084), E.F. Kaner's contribution to this study was supported by an NHS Primary Care Career Scientist Award.
Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2006/11/1
Y1 - 2006/11/1
N2 - This paper describes general practitioners' (GPs) experiences of detecting and managing alcohol and alcohol-related problems in consultations. We undertook qualitative research in two phases in the North-East of England. Initially, qualitative interviews with 29 GPs explored their everyday work with patients with alcohol-related issues. We then undertook group interviews-two with GPs and one with a primary care team-where they discussed and challenged findings of the interviews. The GPs reported routinely discussing alcohol with patients with a range of alcohol-related problems. GPs believed that this work is important, but felt that until patients were willing to accept that their alcohol consumption was problematic they could achieve very little. They tentatively introduced alcohol as a potential problem, re-introduced the topic periodically, and then waited until the patient decided to change their behaviour. They were aware that they could identify and manage more patients. A lack of time and having to work with the multiple problems that patients brought to consultations were the main factors that stopped GPs managing more risky drinkers. Centrally, we compared the results of our study with [Thom, B., & Tellez, C. (1986). A difficult business-Detecting and managing alcohol-problems in general-practice. British Journal of Addiction, 81, 405-418] seminal study that was undertaken 20 years ago. We show how the intellectual, moral, emotional and practical difficulties that GPs currently face are quite similar to those faced by GPs from 20 years ago. As the definition of what could constitute abnormal alcohol consumption has expanded, so the range of consultations that they may have to negotiate these difficulties in has also expanded.
AB - This paper describes general practitioners' (GPs) experiences of detecting and managing alcohol and alcohol-related problems in consultations. We undertook qualitative research in two phases in the North-East of England. Initially, qualitative interviews with 29 GPs explored their everyday work with patients with alcohol-related issues. We then undertook group interviews-two with GPs and one with a primary care team-where they discussed and challenged findings of the interviews. The GPs reported routinely discussing alcohol with patients with a range of alcohol-related problems. GPs believed that this work is important, but felt that until patients were willing to accept that their alcohol consumption was problematic they could achieve very little. They tentatively introduced alcohol as a potential problem, re-introduced the topic periodically, and then waited until the patient decided to change their behaviour. They were aware that they could identify and manage more patients. A lack of time and having to work with the multiple problems that patients brought to consultations were the main factors that stopped GPs managing more risky drinkers. Centrally, we compared the results of our study with [Thom, B., & Tellez, C. (1986). A difficult business-Detecting and managing alcohol-problems in general-practice. British Journal of Addiction, 81, 405-418] seminal study that was undertaken 20 years ago. We show how the intellectual, moral, emotional and practical difficulties that GPs currently face are quite similar to those faced by GPs from 20 years ago. As the definition of what could constitute abnormal alcohol consumption has expanded, so the range of consultations that they may have to negotiate these difficulties in has also expanded.
KW - Alcohol problems
KW - Brief interventions
KW - Doctor-patient interaction
KW - General practice
KW - UK
UR - http://www.scopus.com/inward/record.url?scp=33748549699&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2006.05.025
DO - 10.1016/j.socscimed.2006.05.025
M3 - Article
C2 - 16814441
AN - SCOPUS:33748549699
SN - 0277-9536
VL - 63
SP - 2418
EP - 2428
JO - Social Science and Medicine
JF - Social Science and Medicine
IS - 9
ER -