Screening and brief intervention for excessive alcohol use: qualitative interview study of the experiences of general practitionersBMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7369.870 (Published 19 October 2002) Cite this as: BMJ 2002;325:870
- aCentral Research Unit and Department of General Practice, University of Copenhagen, Panum Institute, DK-2200 Copenhagen, Denmark
- bSection for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Ulriksdal 8c, N-5009 Bergen, Norway
- Correspondence to: Anders Beich
- Accepted 15 August 2002
Objective: To explore the suitability of a screening based intervention for excessive alcohol use by describing the experiences of general practitioners who tried such an intervention in their everyday practice.
Design: Qualitative interviews with general practitioners who had participated in a pragmatic study of a combined programme of screening and a brief intervention for excessive alcohol use. Doctors were interviewed either individually or in focus groups. A computer based, descriptive, phenomenological method was used to directly analyse the digitally recorded interviews.
Setting and participants: 24 of 39 general practitioners in four Danish counties who volunteered to take part in the pragmatic study were interviewed.
Results: The doctors were surprised at how difficult it was to establish rapport with the patients who had a positive result on the screening and to ensure compliance with the intervention. Although the doctors considered the doctor-patient relationship robust enough to sustain targeting of alcohol use, they often failed to follow up on initial interventions, and some expressed a lack of confidence in their ability to counsel patients effectively on lifestyle issues. The doctors questioned the rationale of screening in young drinkers who may grow out of excessive drinking behaviour. The programme needed considerable resources, and it interrupted the natural course of consultations and was inflexible. The doctors could not recommend the screening and brief intervention programme, although they thought it important to counsel their patients on drinking.
Conclusions: Screening for excessive alcohol use created more problems than it solved for the participating doctors. The results underline the value of carrying out pragmatic studies on the suitability of seemingly efficacious healthcare programmes.
Funding This study was supported by the Danish Ministry and Board of Health, the Association of County Councils in Denmark (the Forskningsfonden), and quality development committees in the counties of Vestsjaellands Amt, Storstroems Amt, and Bornholms Amt.