Predictors for hidden problem drinkers in general practice

In The Netherlands general practice attenders are not usually questioned about their drinking habits. The objective of this study was to determine to what extent easily available data (e.g. age, gender) can be used to identify categories of patients who are at risk of problem drinking as a preliminary to more intensive screening. Sixteen practices with a total population of 32,000 patients were involved in the study. All problem drinkers known by their GPs and a random sample of one in ten patients not thought to be problem drinkers were admitted to the study at their first surgery visit during a 1-year period. A screening questionnaire was used to find hidden problem drinkers amongst the individuals thought to be non-problem drinkers. The overall response rate was 91% (n = 1405). Problem drinking was detected in 6% (n = 82) of the group regarded by the GPs as non-problem drinkers (n = 1283). Male gender, smoking, life events and chronic social problems were the strongest non-alcohol-related predictors of hidden problem drinking. We conclude that a pre-selection of patients with a greater risk of problem drinking can be made without information related directly to alcohol. Case-finding in this category is much more effective and probably much more acceptable both to the GP and the patients, than the screening of all patients.