General practitioners, prevention and alcohol - a powerful cocktail? Facilitators and inhibitors of practising preventive medicine in general and early intervention for alcohol in particular: a 12-nation key informant and general practitioner study

This study reports a qualitative investigation of the views of key informan ts (KIs) and general practitioners (GPs) on the nature and extent of preven tive medicine and early alcohol intervention in general practice and the cu rrent barriers and potential facilitating factors that influence practice. Sixty-seven KIs and 126 GPs were interviewed in 12 countries. There was str ong personal and professional support for GP-delivered preventive medicine in general and early intervention for alcohol problems in particular. Opini ons differed on whether national health policies encouraged or discouraged GPs to do more preventive medicine. The two key areas identified for preven tion were smoking and alcohol, although all but two countries thought that alcohol was the most difficult area for GPs to discuss with patients. KIs a nd GPs identified similar barriers and facilitating factors. The main barri ers were time constraints, lack of financial reimbursement or incentives an d insufficient training and education. The main facilitating factors were m ore societal concern about alcohol, proactive patients, more time, financia l reimbursement and supportive government policy.