TY - JOUR
KW - Alcohol drinking consultation drug abuse prescription drugs street drugs substance abuse detection
KW - article
KW - Brief interventions
KW - consultation
KW - General Practice
KW - General Practitioners
KW - Primary Health Care
KW - Screening
AU - Helen J. Moriarty
AU - Maria H. Stubbe
AU - Laura Chen
AU - Rachel M. Tester
AU - Lindsay M. Macdonald
AU - Anthony C. Dowell
AU - Kevin P. Dew
A1 - 
AB - Background. There is a widely held expectation that GPs will routinely use opportunities to provide opportunistic screening and brief intervention for alcohol and other drug (AOD) abuse, a major cause of preventable death and morbidity. Aim. To explore how opportunities arise for AOD discussion in GP consultations and how that advice is delivered. Design. Analysis of video-recorded primary care consultations Setting. New Zealand General Practice. Methods. Interactional content analysis of AOD consultations between 15 GP's and 56 patients identified by keyword search from a bank of digital video consultation recordings. Results. AOD-related words were found in almost one-third (56/171) of the GP consultation transcripts (22 female and 34 male patients). The AOD dialogue varied from brief mention to pertinent advice. Tobacco and alcohol discussion featured more often than misuse of anxiolytics, night sedation, analgesics and caffeine, with only one direct enquiry about other (unspecified) recreational drug use. Discussion was associated with interactional delicacy on the part of both doctor and patient, manifested by verbal and non-verbal discomfort, use of closed statements, understatement, wry humour and sudden topic change. Conclusions. Mindful prioritization of competing demands, time pressures, topic delicacy and the acuteness of the presenting complaint can impede use of AOD discussion opportunities. Guidelines and tools for routine screening and brief intervention in primary care do not accommodate this reality. Possible responses to enhance AOD conversations within general practice settings are discussed. Adapted from the source document.
BT - Family practice
C5 - HIT & Telehealth
CP - 2
CY - United Kingdom
DO - 10.1093/fampra/cmr082
IS - 2
JF - Family practice
N2 - Background. There is a widely held expectation that GPs will routinely use opportunities to provide opportunistic screening and brief intervention for alcohol and other drug (AOD) abuse, a major cause of preventable death and morbidity. Aim. To explore how opportunities arise for AOD discussion in GP consultations and how that advice is delivered. Design. Analysis of video-recorded primary care consultations Setting. New Zealand General Practice. Methods. Interactional content analysis of AOD consultations between 15 GP's and 56 patients identified by keyword search from a bank of digital video consultation recordings. Results. AOD-related words were found in almost one-third (56/171) of the GP consultation transcripts (22 female and 34 male patients). The AOD dialogue varied from brief mention to pertinent advice. Tobacco and alcohol discussion featured more often than misuse of anxiolytics, night sedation, analgesics and caffeine, with only one direct enquiry about other (unspecified) recreational drug use. Discussion was associated with interactional delicacy on the part of both doctor and patient, manifested by verbal and non-verbal discomfort, use of closed statements, understatement, wry humour and sudden topic change. Conclusions. Mindful prioritization of competing demands, time pressures, topic delicacy and the acuteness of the presenting complaint can impede use of AOD discussion opportunities. Guidelines and tools for routine screening and brief intervention in primary care do not accommodate this reality. Possible responses to enhance AOD conversations within general practice settings are discussed. Adapted from the source document.
PB - Oxford University Press
PP - United Kingdom
PY - 2012
SN - 0263-2136, 0263-2136
SP - 213
EP - 222
EP - 
T1 - Challenges to alcohol and other drug discussions in the general practice consultation
T2 - Family practice
TI - Challenges to alcohol and other drug discussions in the general practice consultation
U1 - HIT & Telehealth
U3 - 10.1093/fampra/cmr082
VL - 29
VO - 0263-2136, 0263-2136
Y1 - 2012
ER -