Franz Hanschmidt1, Jakob Manthey2, Ludwig Kraus3,4, Emanuele Scafato5, Antoni Gual6,7,8, Carsten Grimm9,10, Jürgen Rehm2,11,12,13,14. 1. Department of Psychosomatic Medicine, University of Leipzig, Leipzig, Germany. 2. Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, Germany. 3. IFT Institut für Therapieforschung, Parzivalstraße 25, 80804 München, Germany. 4. Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, SE - 106 91 Stockholm, Sweden. 5. Società Italiana di Alcologia (SIA), Viale A. Oriani 2, 40137 Bologna, Italy. 6. Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clinic, Carrer Villarroel 170, 08036 Barcelona, Spain. 7. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Carrer Rosselló 149, 08036 Barcelona, Spain. 8. Red de Trastornos Adictivos (RTA - RETICS), Instituto de Salud Carlos III, Calle Sinesio Delgado 4, 28029 Madrid, Spain. 9. General Practitioner, Moorside Surgery, 370 Dudley Hill Road, BD2 3AA Bradford, UK. 10. Royal College of General Practitioners, 30 Euston Square, NW1 2FB London, UK. 11. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Russell Street, ON M5S 2S1 Toronto, Canada. 12. Addiction Policy, Dalla Lana School of Public Health, University of Toronto, 155 College Street, ON M5T 3M7 Toronto, Canada. 13. Institute of Medical Science, Faculty of Medicine, Medical Sciences Building, University of Toronto, 1 King's College Circle, ON M5S 1A8 Toronto, Canada. 14. Department of Psychiatry, University of Toronto, 250 College Street, ON M5T 1R8 Toronto, Canada.
Abstract
AIMS: 1. To quantify barriers to alcohol screening among hypertensive patients reported by primary healthcare professionals. 2. To examine whether education and screening frequency measures are associated with stigma-related barriers. METHODS: A web survey was conducted among 3081 primary healthcare professionals from France, Germany, Italy, Spain and the UK. Participants were asked about perceived barriers to alcohol screening as free-text response. The replies were independently categorized by two raters. Stigma-related barriers were predicted by logistic regressions with education, knowledge on alcohol as risk factor and frequency of alcohol screening. RESULTS: In France and Italy, almost half of the reported barriers were stigma-related, whereas time constraints were cited most commonly in Spain and the UK. In Germany, nearly half of respondents rated the importance of alcohol screening for hypertension as low. Perception that regular screening is inappropriate or associated with too much effort, beliefs that screening is unnecessary, and insufficient knowledge of screening tools were cited as further barriers. Professional education on alcohol use was consistently rated to be poorer than the equivalent education on hypertension, and only a minority of respondents perceived alcohol as important risk factor for hypertension. Stigma-related barriers could not be significantly predicted by education, knowledge or screening frequency in most models. CONCLUSIONS: Overall, regular alcohol screening among hypertensive patients seems to be widely accepted, but further education (Germany) and structural support (Spain, UK) could contribute to increase screening rates. In France and Italy, screening uptake could be improved by addressing stigma. SHORT SUMMARY: Alcohol screening among hypertensive patients was largely accepted among general practitioners from five different European countries. Reported screening barriers varied between countries and included time constraints, stigma and underrated importance of alcohol. Results did not indicate a positive impact of education and screening frequency on perception of stigma as barrier to screening.
AIMS: 1. To quantify barriers to alcohol screening among hypertensive patients reported by primary healthcare professionals. 2. To examine whether education and screening frequency measures are associated with stigma-related barriers. METHODS: A web survey was conducted among 3081 primary healthcare professionals from France, Germany, Italy, Spain and the UK. Participants were asked about perceived barriers to alcohol screening as free-text response. The replies were independently categorized by two raters. Stigma-related barriers were predicted by logistic regressions with education, knowledge on alcohol as risk factor and frequency of alcohol screening. RESULTS: In France and Italy, almost half of the reported barriers were stigma-related, whereas time constraints were cited most commonly in Spain and the UK. In Germany, nearly half of respondents rated the importance of alcohol screening for hypertension as low. Perception that regular screening is inappropriate or associated with too much effort, beliefs that screening is unnecessary, and insufficient knowledge of screening tools were cited as further barriers. Professional education on alcohol use was consistently rated to be poorer than the equivalent education on hypertension, and only a minority of respondents perceived alcohol as important risk factor for hypertension. Stigma-related barriers could not be significantly predicted by education, knowledge or screening frequency in most models. CONCLUSIONS: Overall, regular alcohol screening among hypertensive patients seems to be widely accepted, but further education (Germany) and structural support (Spain, UK) could contribute to increase screening rates. In France and Italy, screening uptake could be improved by addressing stigma. SHORT SUMMARY: Alcohol screening among hypertensive patients was largely accepted among general practitioners from five different European countries. Reported screening barriers varied between countries and included time constraints, stigma and underrated importance of alcohol. Results did not indicate a positive impact of education and screening frequency on perception of stigma as barrier to screening.
Authors: Julia M Lemp; Supa Pengpid; Doungjai Buntup; Till W Bärnighausen; Pascal Geldsetzer; Karl Peltzer; Jürgen Rehm; Bundit Sornpaisarn; Charlotte Probst Journal: Prev Med Rep Date: 2022-08-19