The overwhelming majority of Maltese excessive drinkers do not feel the need to reduce their alcohol use and are not interested in receiving support or advice from their GP, a study published in the Malta Medical Journal shows.
Eighty-two per cent of heavy drinkers said they did not feel the need to tackle their intake, while 75 per cent of the 400 patients surveyed said that their general practitioner had never initiated a discussion about alcohol use.
Authored by Mario Sammut, the study entitled ‘Lifestyle, prevention, change and support: the views and attitudes of patients in Maltese family practice’ aims to explore the views of Maltese patients about the importance of lifestyle and preventive interventions.
Although he does not quantify his parameters of ‘excessive’, the NHS in Britain recommends men should not regularly drink more than four units of alcohol per day and women not more than three units per day.
Its definition of ‘regularly’ is every day or most days per week.
Dr Sammut’s study also assessed the patients’ readiness to make changes to their lifestyle (in terms of diet, physical activity, weight loss, quitting smoking and safe alcohol consumption) and their willingness to receive support from GPs.
Nine out of 10 patients believe that not smoking, safe/no alcohol use, healthy eating habits, regular physical activity and normal body weight are important for their health. However, fewer patients thought they needed to tackle their harmful lifestyles.
The most striking difference was for alcohol, with a 77 percentage-point disparity between the importance given by patients to safe or no alcohol use and drinkers of excessive alcohol thinking they need to cut down.
Similarly, while about 45 per cent of GPs initiated discussions with patients about eating, physical activity and weight, just 18 per cent of GPs discussed smoking. Only 10 per cent brought up alcohol use.
One possible reason for this, Dr Sammut wrote, could be doctors’ own drinking habits.
Only 37 per cent of Maltese GPs have declared that they do not drink alcohol – indicating that they may find it hard to help patients with behaviours that they struggle with themselves.
A number of significant relationships were found between patients’ contemplation for lifestyle change and provision of support.
Only 37 per cent of Maltese GPs declared they do not drink alcohol
Patients who took part in the survey were more likely to think they needed to improve their eating habits if their GP started a discussion about their body weight or blood pressure.
Smokers were more likely to think they needed to quit if the GP discussed their smoking habits, while drinkers were more likely to think they needed to reduce their alcohol use if this was discussed.
While the apparent reluctance of GPs to engage problem drinkers may be overcome by appropriate training, additional research into alcohol abusers’ poor insight into their predicament and their lack of desire for support could shed some light on these problems and help in the formulation of appropriate solutions, the study says.
The biggest discrepancy between planning to change and confidence in succeeding was for smoking.
Forty-four per cent of smokers were doubtful that they could change their smoking habit.
A further 40 per cent declared they were ‘not at all’ confident of their ability to quit.
While patients do recognise the importance of unhealthy lifestyles, GPs and healthcare professionals need to discuss risky lifestyles with patients to help them personalise such risks, Dr Sammut said.
Furthermore, GPs and healthcare professionals should also offer their support to patients planning to change their unhealthy lifestyles in order to improve their confidence and chances of success.
“Healthcare professionals may play an important role here by providing such assistance, given the heavy workload of general practitioners,” he said.