The Detection and Management of Patients with Excessive Alcohol Consumption in General Practice

Abstract

Several studies have suggested that only a minority of excessive drinkers in the population are known to their general practitioners. We have compared several methods for the detection of excessive alcohol consumption in patients in primary care. In addition we are evaluating the impact of general practitioner intervention on these patients. A self administered questionnaire, the Health Survey Questionnaire (HSQ) was mailed to 3,997 patients registered with two general practices in North West London. Replies were received from 75% of the patients. Of the respondents, 11% males, and 5% females were identified as excessive drinkers (using the limits of 42 units per week or greater for males, and 21 units per week or greater for females). In the practice where a disease register was kept, use of the HSQ resulted in more than four‐fold increase in the number of patients known to be excessive drinkers. Around 45% of the excessive drinkers expressed concern about their drinking. The HSQ compared favourably with a standard drinking interview, breath alcohol measurement and laboratory tests of excessive consumption in the detection of excessive alcohol consumption. This flexible and low cost instrument could be used to increase the detection of excessive drinkers in primary care. We are currently undertaking a pilot randomised trial of the effects of GP intervention in patients with excessive alcohol consumption involving follow up of 60 such patients over one year. A multi centre trial including around 1,000 patients from 10 group practices is planned for 1985.