HOW DO GENERAL-PRACTITIONERS MANAGE ALCOHOL-MISUSING PATIENTS - RESULTS FROM A NATIONAL SURVEY OF GPS IN ENGLAND AND WALES

The appropriateness of the primary care setting to undertake health pr omotional activities has been emphasized, but little is known about th e clinical work of GPs with patients misusing alcohol. This study exam ines how GPs managed alcohol-misusing patients. A 20% random sample of all general practitioners in England and Wales were surveyed using a postal questionnaire. A 44% response rate was achieved. GPs reported m anaging different levels of severity of drinking problems differently, Basic interventions, such as reporting the alcohol misuse diagnosis a nd the provision of advice and information, were routine. Health promo tion leaflets were not used uniformly, even with the less severe probl em drinkers. Detoxification, prescribing of drugs and the management o f medical complications were undertaken mainly with dependent patients . Dependent drinkers were the most Likely group to be referred to spec ialist services, while internal practice referrals occurred with all d rinking status categories. Anti-depressants were the drugs most usuall y prescribed to alcohol-misusing patients. The data point to a need fo r basic guidelines, not only on how to manage and refer dependent drin kers, but also on how to detect and manage those who are not yet manif esting problems but are drinking above recommended guidelines. One of the most evident areas in which there appears to be a need for guideli nes is that of prescribing within primary care.