The role of alcohol in the management of hypertension in patients in European primary health care practices - a survey in the largest European Union countries

TY - JOUR

T1 - The role of alcohol in the management of hypertension in patients in European primary health care practices - a survey in the largest European Union countries

AU - Rehm, Jürgen

AU - Prieto, Jose Angel Arbesu

AU - Beier, Markus

AU - Duhot, Didier

AU - Rossi, Alessandro

AU - Schulte, Bernd

AU - Zarco, José

AU - Aubin, Henri-Jean

AU - Bachmann, Michael

AU - Grimm, Carsten

AU - Kraus, Ludwig

AU - Manthey, Jakob

AU - Scafato, Emanuele

AU - Gual, Antoni

PY - 2016/9/8

Y1 - 2016/9/8

N2 - BACKGROUND: Even though addressing lifestyle problems is a major recommendation in most guidelines for the treatment of hypertension (HTN), alcohol problems are not routinely addressed in the management of hypertension in primary health care.METHODS: Internet based survey of 3081 primary care physicians, recruited via the mailing lists of associations for general practitioners (GPs) in France, Germany, Italy, Spain and the UK. Clinical practice, attitudes, knowledge, education and training were assessed. Logistic regression to predict screening, brief intervention and treatment for alcohol dependence in the management of hypertension were assessed.RESULTS: Overall, about one third of the interviewed GPs reported sufficient screening in cases with HTN (34.0 %, 95 % confidence interval (CI):32.1-35.8 %). One out of five GPs screened and delivered brief interventions in HTN patients with hazardous consumption (22.2 %, 95 % CI: 20.6-23.8 %) and about one in 13 GPs provided treatment for HTN patients with alcohol dependence other than advice or brief intervention (7.8 %, 95 % CI: 6.8-8.9 %). Post-graduate training and belief in their effectiveness predicted interventions. There were marked differences between countries.CONCLUSIONS: While current interventions were overall low, marked differences between countries indicate that current practices could be improved. Education and post-graduate training seems to be key in improving clinical practice of including interventions for problematic alcohol consumption and alcohol dependence in primary health care.

AB - BACKGROUND: Even though addressing lifestyle problems is a major recommendation in most guidelines for the treatment of hypertension (HTN), alcohol problems are not routinely addressed in the management of hypertension in primary health care.METHODS: Internet based survey of 3081 primary care physicians, recruited via the mailing lists of associations for general practitioners (GPs) in France, Germany, Italy, Spain and the UK. Clinical practice, attitudes, knowledge, education and training were assessed. Logistic regression to predict screening, brief intervention and treatment for alcohol dependence in the management of hypertension were assessed.RESULTS: Overall, about one third of the interviewed GPs reported sufficient screening in cases with HTN (34.0 %, 95 % confidence interval (CI):32.1-35.8 %). One out of five GPs screened and delivered brief interventions in HTN patients with hazardous consumption (22.2 %, 95 % CI: 20.6-23.8 %) and about one in 13 GPs provided treatment for HTN patients with alcohol dependence other than advice or brief intervention (7.8 %, 95 % CI: 6.8-8.9 %). Post-graduate training and belief in their effectiveness predicted interventions. There were marked differences between countries.CONCLUSIONS: While current interventions were overall low, marked differences between countries indicate that current practices could be improved. Education and post-graduate training seems to be key in improving clinical practice of including interventions for problematic alcohol consumption and alcohol dependence in primary health care.

KW - Journal Article

U2 - 10.1186/s12875-016-0529-5

DO - 10.1186/s12875-016-0529-5

M3 - SCORING: Journal article

C2 - 27608770

VL - 17

SP - 130

JO - BMC PRIM CARE

JF - BMC PRIM CARE

SN - 1471-2296

IS - 1

ER -