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Abstract
BackgroundPrimary care is an important context for addressing health-related behaviours, and may provide a setting for identification of gambling problems.Aim To indicate the extent of gambling problems among patients attending general practices, and explore settings or patient groups that experience heightened vulnerability.Design and setting Cross-sectional study of patients attending 11 general practices in Bristol, South West England.MethodAdult patients (n = 1058) were recruited from waiting rooms of practices that were sampled on the basis of population characteristics. Patients completed anonymous questionnaires comprising measures of mental health problems (for example, depression) and addictive behaviours (for example, risky alcohol use). The Problem Gambling Severity Index (PGSI) measured gambling problems, along with a single-item measure of gambling problems among family members. Estimates of extent and variability according to practice and patient characteristics were produced.ResultsThere were 0.9% of all patients exhibiting problem gambling (PGSI ≥5), and 4.3% reporting problems that were low to moderate in severity (PGSI 1–4). Around 7% of patients reported gambling problems among family members. Further analyses indicated that rates of any gambling problems (PGSI ≥1) were higher among males and young adults, and more tentatively, within a student healthcare setting. They were also elevated among patients exhibiting drug use, risky alcohol use, and depression.ConclusionThere is need for improved understanding of the burden of, and responses to, patients with gambling problems in general practices, and new strategies to increase identification to facilitate improved care and early intervention.
Highlights
Participation in gambling is increasing in the UK, with surveys indicating that around 59% of British adults reported gambling activities in 2010, which was an increase of 7% from 2007.1 These trends have occurred in the context of developments in gambling technologies and increased exposure,[2] and larger numbers of people experiencing problems with gambling.[1]
The findings suggest around 1 in 20 patients report gambling problems, which were mostly of low to moderate severity, in routine general practice
Exploratory analyses indicated that around 90% of these patients reported gambling on lottery or with instant win tickets only, and suggested that missing data were attributable mainly to such patients failing to define these activities as gambling
Summary
Participation in gambling is increasing in the UK, with surveys indicating that around 59% of British adults reported gambling activities (excluding National Lottery) in 2010, which was an increase of 7% from 2007.1 These trends have occurred in the context of developments in gambling technologies (such as electronic gambling machines and online gambling) and increased exposure (for example, gambling-related advertisements grew by almost 500% between 2007 and 2012),[2] and larger numbers of people experiencing problems with gambling.[1]. Gambling problems cluster with other health-related behaviours,[8] and are associated with anxiety disorders and psychosomatic complaints, and high rates of suicidal ideation and attempts.[9] These problems are associated with overuse of healthcare services, with problem gamblers being twice as likely to consult their GP for mental health concerns, five times as likely to be hospital inpatients, and eight times as likely to access psychological counselling, when compared with people with no such problems.[9] Help seeking for gambling is uncommon, and usually crisis-driven,[10] and occurs only after experiencing severe gamblingrelated harms. Primary care is an important context for addressing health-related behaviours, and may provide a setting for identification of gambling problems
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