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Consultation contexts and the acceptability of alcohol enquiry from general practitioners - a survey experiment
Chun Wah Michael Tam1, Louis Hion-Lam Leong, Nicholas Zwar
1BSc (Med) MBBS MMH (GP) FRACGP, Staff Specialist in General Practice, General Practice Unit, South Western Sydney Local Health District; Conjoint Senior Lecturer, University of New South Wales, Sydney, NSW; RACGP National Research and Evaluation Ethics Committee, NSW.
Background:
General practitioners have a crucial role in detecting risky drinking in patients. However, little is known about how the context of the consultation affect patient acceptability of these discussions.
Methods:
During one week in May 2014, adult patients seen at a community general practice in Sydney were randomised to receive one of two postal questionnaires. Participants rated the acceptability of alcohol enquiry in 20 vignettes of general practice consultations, either within a SNAP (smoking, nutrition, alcohol, physical activity) framework (intervention) or alone (control).
Results:
Of the 441 patients who received the questionnaires, 144 returned completed and returned it. The intervention group rated an additional 2.1 (95% CI = 0.38-3.7, P = 0.016) vignettes as acceptable compared to the control group. Alcohol enquiry acceptability varied greatly between individual scenarios.
Discussion:
Alcohol-use assessment may be more acceptable to patients when it is framed within the SNAP framework, especially in certain presentations (eg diabetes management).
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