Attitudes and management of alcohol problems in general practice: Descriptive analysis based on findings of a world health organization international collaborative survey

Aims: To determine if general practitioners' (GPs) experience of education on alcohol, support in their working environment for intervening with alcohol problems, and their attitudes have an impact on the number of patients they manage with alcohol problems. Methods: 1300 GPs from nine countries were surveyed with a postal questionnaire as part of a World Health Organization (WHO) collaborative study. Results: GPs who received more education on alcohol (OR = 1.5; 95% CI, 1.3-1.7), who perceived that they were working in a supportive environment (OR = 1.6; 95% CI, 1.4-1.9), who expressed higher role security in working with alcohol problems (OR = 2.0; 95% CI, 1.5-2.5) and who reported greater therapeutic commitment to working with alcohol problems (OR = 1.4: 95% CI, 1.1-1.7) were more likely to manage patients with alcohol-related harm. Conclusion: Both education and support in the working environment need to be provided to enhance the involvement of GPs in the management of alcohol problems.

Network structures: Working differently and changing expectations

There is a growing need for innovative methods of dealing with complex, social problems. New types of collaborative efforts have emerged as a result of the inability of more traditional bureaucratic hierarchical arrangements such as departmental program, to resolve these problems. Network structures are one such arrangement that Is at the forefront of this movement. Although collaboration through network structures establishes an innovative response to dealing with social issues, there remains an expectation that outcomes and processes are based on traditional ways of working. It is necessary for practitioners and policy makers alike to begin to understand the realities of what can be expected from network structures in order to maximize the benefits of these unique mechanisms.