Impact of alcohol education and training on general practitioners' diagnostic and management skills: Findings from a World Health Organization collaborative study

Objective: The potential of general practitioners (GPs) to reduce the preva lence of alcohol-related problems via alcohol intervention contrasts sharpl y with actual practice. One explanation for GPs' limited involvement in alc ohol intervention is that they have had inadequate training or continuing m edical education (CME) on alcohol-related issues. This study examined GPs' experience of alcohol-related CME and its possible relationship with attitu des and practice behavior regarding alcohol-related problems. Method: A que stionnaire-based survey was returned by 2,139 GPs from 13 countries across Western and Eastern Europe, North America and Australasia. Diagnostic and m anagement skills were assessed by responses to standardized case vignettes. Results: The survey response rate was 54%. Approximately one third of GPs (32%) reported receiving no alcohol-related CME, while 8% could not remembe r whether or not they had received any such training or education. Of the r emaining GPs (n = 1,217), 23% reported less than 4 hours (low levels) and 3 7% reported 4 or more hours (high levels) of alcohol-related CME. GPs who r eported higher levels of alcohol-related CME were more likely to obtain inf ormation about alcohol, were more prepared to counsel problem drinkers and managed more patients for alcohol issues than did colleagues reporting lowe r levels of CME. Those with greater CME experience were also more confident about their ability to alleviate alcohol-related problems and reported mor e appropriate management strategies than did GPs with less CME experience. Conclusions: Greater exposure to alcohol-related CME appears to result in b etter diagnosis and more appropriate management of alcohol-related problems by GPs. Whether this is directly due to the CME itself or because GPs with greater interest in alcohol issues seek out such experience cannot be asce rtained from the current study and requires further investigation.