Abstract
BackgroundOne in five Australians consume alcohol at risky or harmful levels. Most (85%) attend a general practitioner at least once a year, giving opportunity for detecting and providing brief interventions for reducing alcohol-related harm. Historically, detection rates of problem drinking have been low in general practice, producing lower prevalence estimates of heavy drinking than expected from population surveys.MethodThe BEACH program collects data from 100 consecutive patient consultations with 1000 GPs annually. For 40 consecutive encounters, GPs ask adult patients three questions on alcohol consumption (AUDIT-C). This paper reports the problems managed and treatments provided at encounters with heavy and non-heavy drinkers, grouped by their response to the 3rd question, and compares the two groups before and after standardisation for age and sex. Heavy drinking was defined as having 6 or more standard drinks at least once a week or more often.ResultsHeavy drinking was reported by 7.3% patients overall; more prevalent among men (13.8%) than women (3.9%); and among Indigenous patients (18.5%). Prevalence was highest in young adults (18–24 years)(12.7%) and decreased with age. Patients from a non-English speaking background were less likely to be heavy drinkers. Heavy drinkers had more problems managed at encounters, more chronic problems, physical injuries and psychological problems (particularly depression) managed than non-heavy drinkers. They were less likely to have respiratory complaints, ischaemic heart disease or diabetes managed.ConclusionHeavy drinkers are more likely than non- or light drinkers to see their GP for management of chronic problems, psychological problems and physical injuries. However, the wide range of morbidity managed in heavy drinkers means that relying on clinical impression alone to detect this group will not suffice and should be augmented with routine screening. Given the pressures of general practice, finding efficient methods of screening for alcohol problems remains a priority.
Highlights
One in five Australians consume alcohol at risky or harmful levels
Heavy drinkers had more problems managed at encounters, more chronic problems, physical injuries and psychological problems managed than non-heavy drinkers
Heavy drinkers are more likely than non- or light drinkers to see their general practice (GP) for management of chronic problems, psychological problems and physical injuries
Summary
One in five Australians consume alcohol at risky or harmful levels. Most (85%) attend a general practitioner at least once a year, giving opportunity for detecting and providing brief interventions for reducing alcohol-related harm. It contributes to health care costs through general practice (GP) and emergency department presentations and hospital admissions. It can impact on the individual and family quality of life and can lead to early death. And brief intervention has been demonstrated to be effective for management of excessive alcohol use and is cost-effective [3,4,5]. In contrast as few as 30% of alcohol problems are said to be recognised by either GPs [6,7] or hospital doctors [8,9,10]
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