Identification of smokers, drinkers and risky drinkers by general practitioners
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Identification of smokers, drinkers and risky drinkers by general practitioners.

Manthey J., Probst C., Hanschmidt F. et al.
Drug and Alcohol Dependence: 2015, 154, p. 93–99.
Unable to obtain a copy by clicking title? Try asking the author for a reprint by adapting this prepared e-mail or by writing to Dr Manthey at You could also try this alternative source.

Across six European countries, during normal consultations primary care doctors correctly identified 65% of their adult patients as current drinkers, and diagnosed as problem drinkers under a third of those whose responses during interviews with researchers were indicative of risky drinking.

Summary Identification of risky substance users by general practitioners (GPs) is important for providing brief interventions or to refer cases to specialised care, but detection rates of risky users are low, and drinkers are identified less frequently than smokers.

The featured study compared assessments by GPs of patients seen during normal primary care practice against the results of research interviews with the same patients. The assessments included tobacco use, number of cigarettes smoked daily, alcohol use, alcohol use disorder, and whether the patient met several criteria for risky drinking. The study involved 358 GPs and 8476 adult primary care patients in Germany, Hungary, Italy, Latvia, Poland, and Spain.

GPs correctly identified 88% of the smokers among their patients but only 65% of the current drinkers, and for 1 in 9 patients declared themselves unable to say whether they were a drinker. GPs’ estimates of the number of cigarettes smoked daily were slightly lower than those of the patients themselves, but the more the patient said they smoked, the higher the GPs’ estimates tended to be. Just 29% of the risky drinkers (alcohol-related problems or risky drinking patterns) identified through research interviews were seen by their GPs as having a drink problem. Conversely, of those patients judged to be problem drinkers by their GPs, less than half reported at least one problem themselves and even fewer admitted to researchers to being heavy drinkers. Patients with health problems due to drinking were much more likely to be identified by their GPs as problem drinkers.

The authors concluded that GPs in the study were better at identifying smokers than drinkers. They failed to diagnose a sizeable proportion of risky drinkers, but were able to detect other drinkers missed by research interviews. European GPs seem to identify risky drinkers mostly via alcohol-related health problems, but other risky drinkers, such as patients predominantly with psychological problems, may be overlooked by current diagnostic routines.

Last revised 12 October 2015. First uploaded 08 October 2015

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