Aims: To analyze the current paradigm and clinical practice for dealing with alcohol use disorders (AUD) in primary health care. Methods: Analyses of guidelines and recommendations, reviews and meta-analyses. Results: Many recommendations or guidelines for interventions for peoplewith alcohol use problems in primary health care, from hazardous drinking to AUD, can be summarized in the SBIRT principle: screening for alcohol use and alcohol-related problems, brief interventions for hazardous and in some cases harmful drinking, referral to specialized treatment for people with AUD. However, while there is some evidence that these procedures are effective in reducing drinking levels, they are rarely applied in clinical practice in primary health care, and no interventions are initiated, even if the primary care physician had detected problems or AUD. Rather than asking primary health care physicians to conduct interventions which are not typical for medical doctors, we recommend treatment initiation for AUD at the primary health care level. AUD should be treated like hypertension, i.e. with regular checks for alcohol consumption, advice for behavioral interventions in case of consumption exceeding thresholds, and pharmaceutical assistance in case the behavioral interventions were not successful. Minimally, alcohol consumption should be screened for in all situations where there is a co-morbidity with alcohol being a potential cause (such as hypertension, insomnia, depression or anxiety disorders).

Alcohol Use Disorders in Primary Health Care: What Do We Know and Where Do We Go?

STRUZZO, PIERLUIGI;
2016-01-01

Abstract

Aims: To analyze the current paradigm and clinical practice for dealing with alcohol use disorders (AUD) in primary health care. Methods: Analyses of guidelines and recommendations, reviews and meta-analyses. Results: Many recommendations or guidelines for interventions for peoplewith alcohol use problems in primary health care, from hazardous drinking to AUD, can be summarized in the SBIRT principle: screening for alcohol use and alcohol-related problems, brief interventions for hazardous and in some cases harmful drinking, referral to specialized treatment for people with AUD. However, while there is some evidence that these procedures are effective in reducing drinking levels, they are rarely applied in clinical practice in primary health care, and no interventions are initiated, even if the primary care physician had detected problems or AUD. Rather than asking primary health care physicians to conduct interventions which are not typical for medical doctors, we recommend treatment initiation for AUD at the primary health care level. AUD should be treated like hypertension, i.e. with regular checks for alcohol consumption, advice for behavioral interventions in case of consumption exceeding thresholds, and pharmaceutical assistance in case the behavioral interventions were not successful. Minimally, alcohol consumption should be screened for in all situations where there is a co-morbidity with alcohol being a potential cause (such as hypertension, insomnia, depression or anxiety disorders).
2016
15-nov-2015
Pubblicato
http://dx.doi.org/10.1093/alcalc/agv127
File in questo prodotto:
File Dimensione Formato  
Rehm et al., 2015 Alc Alc AUD in PHC epub.pdf

Accesso chiuso

Tipologia: Documento in Versione Editoriale
Licenza: Digital Rights Management non definito
Dimensione 180.46 kB
Formato Adobe PDF
180.46 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11368/2848472
Citazioni
  • ???jsp.display-item.citation.pmc??? 53
  • Scopus 114
  • ???jsp.display-item.citation.isi??? 114
social impact