Involvement of general practitioners in managing alcohol problems: a randomized controlled trial of a tailored improvement programme
Article first published online: 8 MAY 2012
© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction
Volume 107, Issue 9, pages 1601–1611, September 2012
How to Cite
van Beurden, I., Anderson, P., Akkermans, R. P., Grol, R. P. T. M., Wensing, M. and Laurant, M. G. H. (2012), Involvement of general practitioners in managing alcohol problems: a randomized controlled trial of a tailored improvement programme. Addiction, 107: 1601–1611. doi: 10.1111/j.1360-0443.2012.03868.x
- Issue published online: 2 AUG 2012
- Article first published online: 8 MAY 2012
- Accepted manuscript online: 28 FEB 2012 12:00AM EST
- Submitted 11 March 2010; initial review completed 28 April 2010; final version accepted 22 February 2012
- brief interventions;
- family practice;
Aims To assess the effect of a tailored multi-faceted improvement programme on general practitioners' (GPs') behaviour towards prevention of hazardous and harmful alcohol consumption. The improvement programme consisted of activities aimed at the GP, organization and patient. Educational training sessions and visits by a facilitator were tailored to the GPs' needs and attitudes.
Design Cluster randomized controlled trial.
Setting General practices in the Netherlands.
Participants Seventy-seven general practices; 119 GPs participated. Data from 6318 patients were available, of whom 765 (12.1%) were at risk. A total of 1502 patients' electronic medical records were reviewed.
Measurements The primary outcome was the number of eligible patients who received screening and advice.
Findings Difficulties in recruiting GPs and in motivating GPs for participation in the tailored parts of the programme impeded optimal implementation of the programme. Although GPs in both groups became more involved after enrolment, this improvement waned during the trial. The quality improvement programme enhanced the initial improvement in behaviour and it tempered waning (intervention group), compared to our control condition, resulting in average improvement rates of 5% (screening) and 2% (advice-giving) at 12-month follow-up (not significant).
Conclusions A tailored, multi-faceted programme aimed at improving general practitioner management of alcohol consumption in their patients failed to show an effect and proved difficult to implement. There remains little evidence to support the use of such an intensive implementation programme to improve the management of harmful and hazardous alcohol consumption in primary care.