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Physicians' attitudes toward unhealthy alcohol use and self-efficacy for screening and counseling as predictors of their counseling and primary care patients' drinking outcomes.
Elwy AR, Horton NJ, Saitz R. Physicians' attitudes toward unhealthy alcohol use and self-efficacy for screening and counseling as predictors of their counseling and primary care patients' drinking outcomes. Substance abuse treatment, prevention, and policy. 2013 May 30; 8(1):17.
Patients' unhealthy alcohol use is often undetected in primary care. Our objective was to examine whether physicians' attitudes and their perceived self-efficacy for screening and counseling patients is associated with physicians' counseling of patients with unhealthy alcohol use, and patients' subsequent drinking.
This study is a prospective cohort study (nested within a randomized trial) involving 41 primary care physicians and 301 of their patients, all of whom had unhealthy alcohol use. Independent variables were physicians' attitudes toward unhealthy substance use and self-efficacy for screening and counseling. Outcomes were patients' reports of physicians' counseling about unhealthy alcohol use immediately after a physician visit, and patients' drinking six months later.
Neither physicians' attitudes nor self-efficacy had any impact on physicians' counseling, but greater perceived self-efficacy in screening, assessing and intervening with patients was associated with more drinking by patients six months later.
Future research needs to further explore the relationship between physicians' attitudes towards unhealthy alcohol use, their self-efficacy for screening and counseling and patients' drinking outcomes, given our unexpected findings.