Diagnostik und Behandlung alkoholbezogener Störungen -- Ergebnisse einer Umfrage in hausärztlichen Praxen

TY - JOUR

T1 - Diagnostik und Behandlung alkoholbezogener Störungen -- Ergebnisse einer Umfrage in hausärztlichen Praxen

AU - Berner, M M

AU - Zeidler, C

AU - Kriston, L

AU - Mundle, G

AU - Lorenz, G

AU - Härter, M

PY - 2006/3

Y1 - 2006/3

N2 - BACKGROUND: Due to their high prevalence alcohol related disorders (dependent, harmful and at risk drinking) are of major importance for the general practitioner (GP). The aim of this study was to examine the diagnostic and treatment strategies employed by the general practitioners.METHODS: A standardized 10-page questionnaire was mailed to a representative sample (n = 1232) of the general practitioners in south-west Germany. They were asked about diagnostic and therapeutic procedures they had employed in the last patient seen. Further questions regarded patient-related and structural problems. The response rate was 24.3 %.RESULTS: The reported patients had a mean age of 49 +/- 10.3 years. 70.6 % were of male sex. The mean duration of the last patient contact was 18.7 minutes. The diagnosis originated more in clinical impression than in use of screening instruments (0.7 % of patients) or formal diagnostic criteria. 76.7 % fulfilled ICD-10 criteria for dependent drinking, 65.0 % were judged dependent drinkers by the GP's. In most cases the patient had been referred to inpatient services. The main intervention (97.3 % of cases) was disease related counseling. 69.4 % were judged to be quite ill and severely ill. In most cases an inpatient referral had taken place. Pharmacotherapeutic measures were relatively rarely employed (11.3 %). As the major impediments of treatment patient related factors were stated (lack of acceptance of diagnosis, resistance to treatment).DISCUSSION: The majority of patients described by the GP's were dependent drinkers. This indicates that many at risk drinkers might perhaps not be correctly identified. Concerning therapeutic competency patient-related factors are considered as the major impediments for the delivery of effective care. This reflects a view of GP's that patients with alcohol problems are being difficult and time consuming. This should be carefully addressed by future GP-education programs.

AB - BACKGROUND: Due to their high prevalence alcohol related disorders (dependent, harmful and at risk drinking) are of major importance for the general practitioner (GP). The aim of this study was to examine the diagnostic and treatment strategies employed by the general practitioners.METHODS: A standardized 10-page questionnaire was mailed to a representative sample (n = 1232) of the general practitioners in south-west Germany. They were asked about diagnostic and therapeutic procedures they had employed in the last patient seen. Further questions regarded patient-related and structural problems. The response rate was 24.3 %.RESULTS: The reported patients had a mean age of 49 +/- 10.3 years. 70.6 % were of male sex. The mean duration of the last patient contact was 18.7 minutes. The diagnosis originated more in clinical impression than in use of screening instruments (0.7 % of patients) or formal diagnostic criteria. 76.7 % fulfilled ICD-10 criteria for dependent drinking, 65.0 % were judged dependent drinkers by the GP's. In most cases the patient had been referred to inpatient services. The main intervention (97.3 % of cases) was disease related counseling. 69.4 % were judged to be quite ill and severely ill. In most cases an inpatient referral had taken place. Pharmacotherapeutic measures were relatively rarely employed (11.3 %). As the major impediments of treatment patient related factors were stated (lack of acceptance of diagnosis, resistance to treatment).DISCUSSION: The majority of patients described by the GP's were dependent drinkers. This indicates that many at risk drinkers might perhaps not be correctly identified. Concerning therapeutic competency patient-related factors are considered as the major impediments for the delivery of effective care. This reflects a view of GP's that patients with alcohol problems are being difficult and time consuming. This should be carefully addressed by future GP-education programs.

KW - Adult

KW - Aged

KW - Alcohol-Related Disorders

KW - Data Collection

KW - Family Practice

KW - Female

KW - Germany

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Acceptance of Health Care

U2 - 10.1055/s-2005-870949

DO - 10.1055/s-2005-870949

M3 - SCORING: Zeitschriftenaufsatz

C2 - 16528639

VL - 74

SP - 157

EP - 164

JO - FORTSCHR NEUROL PSYC

JF - FORTSCHR NEUROL PSYC

SN - 0720-4299

IS - 3

ER -