EARLY INTERVENTION FOR ALCOHOL-USE - FAMILY PHYSICIANS MOTIVATIONS AND PERCEIVED BARRIERS

Objective: To elucidate family physicians' motivations concerning earl y intervention for alcohol use and their perceived barriers to such in tervention. Design: Qualitative study with the use of focus groups and semistructured interviews. Setting: Community-based, fee-for-service family-medicine practices in London, Ont. Participants: Twelve focus-g roup participants recruited through telephone contact by two family ph ysicians on the project team. Participants were required to be physici ans in family practice in London. Twelve interview participants recrui ted through a grand-rounds presentation at two local hospitals. Partic ipants were required to be physicians in a community-based family prac tice in which primary care was not delivered by residents and to have agreed to participate in all phases (e.g., needs assessment, training and evaluation) of a training program on interventions to help patient s reduce alcohol consumption or quit smoking. Main outcome measures: M otivations concerning early intervention for alcohol use and perceived barriers to such intervention, as identified by physicians. Results: Physicians in the focus groups and those interviewed endorsed their ro le in helping patients to reduce alcohol consumption and cited several reasons for the importance of that role. There was strong support for viewing alcohol use as a lifestyle issue to be dealt with in the cont ext of a holistic approach to patient care. Participants cited many ba rriers to fulfilling their role and were particularly concerned about the appropriateness of asking all adolescent and adult patients about alcohol use, even at visits intended to discuss other issues and conce rns. Physicians gave several motivations for improving their work in r eduction of alcohol consumption, including their current frustration w ith the lack of a systematic strategy or tangible materials to help th em identify and manage patients. Conclusions: Interventions with patie nts who use alcohol should be framed in the context of a holistic appr oach to family medicine. Qualitative knowledge of the motivations and barriers affecting physicians can inform future research and education al strategies in this area.