Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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A Good initiative
- Mahidhar Godavarti (8 September 2006)
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Gps are not reluctant to get involved in caring for alcohol users
- James M Mather (8 September 2006)
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Pushing the Front Lines
- Javad S. Fadardi (15 September 2006)
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Mahidhar Godavarti, Gp Registrar Norton Medical Center, Stockton on Tees, TS20 2UZ
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I agree with Robin Touquet and Alex Paton, the authors with regards to the management of alcohol problems more at the frontline. In Norton Medical Centre we have got a GP with special interest and an Alcohol and dependence worker who visits the surgery once a week and provides service. This service is very good and effective in tackling alcohol patients at the primary care level. The problem arises when the patient attends the A&E for the first time with alcohol problem when he never attended the Gp in the past with that problem. We should have a more efficient system of recognising these patients in the primary care, probably by assessing the alcoholism habit on a regular basis in primary care. For example if on a routine visit if we have identified a patient to be a regular alcohol abuser, probably introduce a routine questionnaire in the follow up visit. The best way of implementing this would be introducing a QOF target for follow up of high risk patients. The second initiative would be to probably maintain a register of patients who have an alcohol problem and arrange an annual care plan for these patients so that they get adequate advice and make sure they don’t progress into secondary care. Competing interests: None declared |
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James M Mather, GP Malvern Worcestershire
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It does not seem to follow from the 7th reference for this editorial that GPs are frequently reluctant to get involved in caring for alcohol users. Also I fail to see how a study that has the objective "to evaluate the efficacy and relative costs of different screening methods for the identification of alcohol use disorders in an opportunistic screening programme in primary care in the United Kingdom" can be used as a reference to draw that conclusion! I would argue that primary care is the first port of call for many known alcohol users who are endangering their health and often responds well to this difficult problem with limited resources. However I would agree that in primary care the problem is not always detected as effectively as it should be again due to lack of time not due to a reluctance to get involved. Competing interests: None declared |
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Javad S. Fadardi, Researcher at University of Wales, Bangor LL57 2AS
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Although tackling the alcohol problems at its early stages by GPs would prove useful, yet, challenging the early causes of the behaviour seems even more important. There are emotional and motivational needs that fuel the behaviour; most of them originating from the abusers’ family and educational settings. Preventive programmes need be introduced into the society’s care and educational systems, while emphasising on the motivational reasons behind the problem; meanwhile, the society should limit the explicit and implicit messages on the benefits of alcohol consumption. The results of a recent review shows that, for example, the good effects of moderate drinking on coronary disorders have been overestimated. At the University of Wales, Bangor we (Cox, Fadardi, Hosier) are introducing a Life Enhancement and Achievement Programme (LEAP) that aims at increasing drinkers’ perceived happiness through helping them enhance their quality of lives and success; thereby, reducing their underlying need to manipulate their feelings chemically. Competing interests: Motivation Matters |
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