Interventions Done by Health Care Professionals for Patients with Problem Drinking Admitted to Teaching Hospital Karapitiya

Abstract

Problem drinking (PD), namely alcohol dependence (AD) and alcohol abuse (AA) are associated with major medical, social and economic adverse consequences. The aim is to determine the nature of interventions done by healthcare professionals (HCPs) for patients with PD admitted to a tertiary-care hospital in Southern Sri-Lanka. Two-hundred consecutively admitted male patients with a history of alcool consumption receiving care in medical and surgical wards in Teaching-Hospital Karapitiya were assessed. Validated J12 questionnaire of the Mini-International-Neuropsychiatric-Interview (MINI) was administered to determine frequency of PD. Semi-structured interviews were conducted to determine the nature of interventions i.e. whether they were brief interventions or long-term treatment and follow up interventions, and also to determine who the intervening HCPs were. PD was noted in 63 (31.5%) participants. Of them, 55.5% were never advised on PD behavior despite frequent encounters with the HCPs. Among those who had interventions, 67.9% had ‘very brief interventions’, where the HCP provided information on adverse health effects of alcohol consumption and requested patients to reduce or abstain from drinking. Medical officers (MOs) were involved in 85.7% of instances and nursing officers (NOs) in 14.3%. In 32.1% with PD, referrals were made to specialist psychiatry services for long-term treatment and follow up. A high proportion of those who consumed alcohol had PD. Though the problem drinkers require intensive, focused alcohol cessation interventions, most did not receive interventions at all or received only very brief interventions which are unlikely to help overcome PD. Though in many countries alcohol cessation services are manned by members of the medical team other than doctors, such as nurses, their involvement was minimal in the hospital in Southern Sri Lanka considered for the present study.