• Jürgen Rehm, PrietoJose Angel ArbesuJAPrimary Health Care Center La Eria Oviedo, Oviedo, Spain.Primary Care Spanish Society SEMERGEN, Madrid, Spain., Markus Beier, Didier Duhot, Alessandro Rossi, Bernd Schulte, José Zarco, Henri-Jean Aubin, Michael Bachmann, Carsten Grimm, Ludwig Kraus, Jakob Manthey, Emanuele Scafato, and Antoni Gual.
• Social and Epidemiological Research Department, Centre for Addiction and Mental Health, Toronto, Canada.
• Bmc Fam Pract. 2016 Sep 8; 17 (1): 130130.

BackgroundEven though addressing lifestyle problems is a major recommendation in most guidelines for the treatment of hypertension (HTN), alcohol problems are not routinely addressed in the management of hypertension in primary health care.MethodsInternet based survey of 3081 primary care physicians, recruited via the mailing lists of associations for general practitioners (GPs) in France, Germany, Italy, Spain and the UK. Clinical practice, attitudes, knowledge, education and training were assessed. Logistic regression to predict screening, brief intervention and treatment for alcohol dependence in the management of hypertension were assessed.ResultsOverall, about one third of the interviewed GPs reported sufficient screening in cases with HTN (34.0 %, 95 % confidence interval (CI):32.1-35.8 %). One out of five GPs screened and delivered brief interventions in HTN patients with hazardous consumption (22.2 %, 95 % CI: 20.6-23.8 %) and about one in 13 GPs provided treatment for HTN patients with alcohol dependence other than advice or brief intervention (7.8 %, 95 % CI: 6.8-8.9 %). Post-graduate training and belief in their effectiveness predicted interventions. There were marked differences between countries.ConclusionsWhile current interventions were overall low, marked differences between countries indicate that current practices could be improved. Education and post-graduate training seems to be key in improving clinical practice of including interventions for problematic alcohol consumption and alcohol dependence in primary health care.

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