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332991
Patients with Excessive Alcohol Consumption in Primary Health Care: A Survey of GPs' and psychiatrists' Attitudes and Practices in two states in Germany


Tuesday, November 3, 2015

Thomas Hoffmann, Department of Health Sciences / Public health, TU Dresden, Dresden, Germany
Karen Voigt, Department of General Medicine, Dresden Medical School, TU Dresden, Dresden, Germany
Lydia Schlisske, Department of Health Sciences / Public health, TU Dresden, Dresden, Germany
Axel Bartels, Department of General Medicine, Dresden Medical School, TU dDesden, Germany
Antje Bergmann, Department of General Medicine, TU Dresden, Dresden, Germany
Joachim Kugler, Prof. Dr.med. Dipl.-Psych., Department of Health Sciences / Public health, Full Professor for Health Sciences / Public health, Dresden Medical School, TU Dresden, Dresden 01309, Germany
Introduction:

Harmful alcohol consumption in Germany is  a serious public health problem: a)  about 9,5 M adults in Germany can be classified as risky alcohol consumer ; b)  about 74.000 deaths per year are related to alcohol consumption; c) about 1,3 M adults in Germany (18 – 64 y) are classified as alcohol dependant (3,4% m, 1,4 % w)(see German Centre for Addiction Issues, yearbook 2014).

In this study, we focused on attitudes and interventions of general practitioners and psychiatrists in the state of Saxony and Rhineland-Palatinate in Germany

Methods:

A total of 6.324 general practitioners (GPs) and psychiatrists in both states were asked to participate in this survey.  957 could be included in the statistical analysis (response rate: 15.1 %).

Results:

The majority of german GPs (about 88 %) see alcohol abuse as an important issue in their medical practice. While more than 70 % of the GPs are motivated to work with harmful drinker, only 23% find that it is rewarding. Just 43 % of the German GPs feel sufficiently trained to counsel patients with alcohol problems, especially if compared with psychiatrists (78%). Regression analysis reveals that GPs who felt not adequaetely trained had less experience with alcohol patients (OR 5.1), had attended less hours on alcohol addiction in continuing medical education (OR 3.7), had a practise in a rural setting (OR 1.9) and were more likely to be female (OR 1.6).

Discussion:

Harmful drinking is a serious public health problem which is often diagnosed and treated in primary health care. This study shows that there are severe barriers to work with this patient group including lack of training.

Learning Areas:

Administer health education strategies, interventions and programs
Clinical medicine applied in public health
Other professions or practice related to public health
Provision of health care to the public

Learning Objectives:
Define barriers in treatment of patients wieh harmful alcohol consumption in primary health care, Describe general practitioners who feel inadequaetly trained in treatin patients wirh alcohol problems

Keyword(s): Alcohol Use, Primary Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal of multiple funded grants by the german statutory health insurers focusing on the quality of health care. I have published more than 200 papers on various aspects of health care. As a professor of public health, I encourage Ph.D. students to do research in this field.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.