The role of alcohol in the management of hypertension in patients in European primary health care practices - a survey in the largest European Union countries - PubMed (original) (raw)

doi: 10.1186/s12875-016-0529-5.

Jürgen Rehm 1 2 3 4 5 6, Markus Beier 9, Didier Duhot 10 11 12, Alessandro Rossi 13, Bernd Schulte 14, José Zarco 15 16 17, Henri-Jean Aubin 18 19, Michael Bachmann 20, Carsten Grimm 21 22, Ludwig Kraus 23 24, Jakob Manthey 25 26, Emanuele Scafato 27 28 29, Antoni Gual 30 31 32

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The role of alcohol in the management of hypertension in patients in European primary health care practices - a survey in the largest European Union countries

Jürgen Rehm et al. BMC Fam Pract. 2016.

Abstract

Background: Even though addressing lifestyle problems is a major recommendation in most guidelines for the treatment of hypertension (HTN), alcohol problems are not routinely addressed in the management of hypertension in primary health care.

Methods: Internet based survey of 3081 primary care physicians, recruited via the mailing lists of associations for general practitioners (GPs) in France, Germany, Italy, Spain and the UK. Clinical practice, attitudes, knowledge, education and training were assessed. Logistic regression to predict screening, brief intervention and treatment for alcohol dependence in the management of hypertension were assessed.

Results: Overall, about one third of the interviewed GPs reported sufficient screening in cases with HTN (34.0 %, 95 % confidence interval (CI):32.1-35.8 %). One out of five GPs screened and delivered brief interventions in HTN patients with hazardous consumption (22.2 %, 95 % CI: 20.6-23.8 %) and about one in 13 GPs provided treatment for HTN patients with alcohol dependence other than advice or brief intervention (7.8 %, 95 % CI: 6.8-8.9 %). Post-graduate training and belief in their effectiveness predicted interventions. There were marked differences between countries.

Conclusions: While current interventions were overall low, marked differences between countries indicate that current practices could be improved. Education and post-graduate training seems to be key in improving clinical practice of including interventions for problematic alcohol consumption and alcohol dependence in primary health care.

Keywords: Alcohol use disorders; Blood pressure; Disease management; Hazardous drinking; Hypertension; Primary health care; Screening.

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