Alcohol and brief intervention in primary health care: what do patients think?

Abstract

Excessive alcohol consumption causes major problems in the UK but is responsive to brief intervention. Excessive drinkers represent 20% of patients on practice lists and present twice as often as others. The potential of health professionals to reduce alcohol related problems contrasts sharply with current practice. Health professionals’ report fears about negative reactions and losing rapport with patients. This study explored patients’ attitudes to and experiences of alcohol and brief intervention in primary health care so that health professionals can provide a service which is more acceptable to patients. The study used a qualitative approach to data collection and analysis. Six focus groups, stratified by age and sex, were conducted with 31 patients from practices in northeast England. A combination of random and purposive sampling was used to recruit patients with a range of perspectives on issues emerging from ongoing data-analysis until data saturation occurred. Many patients had recently altered their lifestyle to improve their health, however, only one reported reducing alcohol consumption. Over half the patients had been advised about their lifestyle but this was not always deemed to be appropriate. Patients responded positively to advice when in an appropriate context and by a health professional with whom they had developed a relationship and rapport. Overall the general practitioner was deemed the preferred health professional to discuss alcohol issues. Brief alcohol intervention is a legitimate role of the general practitioner when carried out in an appropriate context. A National Alcohol Strategy should focus on strengthening the public health campaign in order to support general practitioners in brief alcohol intervention.