General-practitioner-led alcohol and other drugs withdrawal: Supporting patient choice, safety and success.

BACKGROUND: Alcohol or other drug (AOD) withdrawal is a common reason for patients to seek treatment. Ambulatory, or 'home-based', AOD withdrawal for patients who are low risk is a useful intervention for general practitioners (GPs) to help empower their patients to improve their health and make meaningful change to their AOD use. OBJECTIVE: This article explores the themes of patient choice, safety and optimising success in GP-led withdrawal. The four-step framework of 'who', 'prepare', 'withdrawal' and 'follow-up' outlines how to best support patients in the general practice setting to undertake a withdrawal. DISCUSSION: There are many benefits to a GP-led, home-based AOD withdrawal. The strategies to facilitate choice and safety and to optimise withdrawal success described in the article include careful patient selection, preparing the patient using domains of whole-person care, clarifying the patient's goals and stage of change, support during withdrawal and fostering long-term treatment in general practice.

Engaging patients who use alcohol and other drugs: A practical approach.

BACKGROUND: The treatment of alcohol and other drugs (AOD)-related issues is an essential skill for all general practitioners (GPs). The ongoing harm and significant burden of disease experienced by people who use AOD, as well as the impact of this on their families and communities, displays the need for engagement and upskilling in this clinical area. OBJECTIVE: Provide GPs with a clear and practical approach to supporting patients who use AOD. DISCUSSION: Historically, AOD use has been associated with shame, societal judgement and a punitive treatment approach. These factors have been shown to adversely affect treatment outcomes, including a significant delay to, and low engagement with, treatment. An approach focusing on rapport and the therapeutic alliance is best practice and incorporates a strengths-based approach of whole-person, trauma-informed care and motivational interviewing to support behaviour change.

Impact of Australian general practice alcohol and other drugs education: a qualitative evaluation.

BACKGROUND: Many GPs are challenged to deliver safe and effective care for patients who use alcohol and other drugs (AOD). The Royal Australian College of General Practitioners (RACGP) developed the AOD GP Education Programme to support Australian GPs and optimise AOD care in the community. How the programme impacted GP participants is not yet fully understood. AIM: To explore the views and experiences of GP participants who completed the AOD GP Education Programme, and AOD experts who were involved in the programme as a presenter or mentor. DESIGN & SETTING: Situated in the constructivist paradigm, this qualitive descriptive study engaged GPs across Australia. METHOD: This study employed semi-structured, online, focus groups interviews. Data were analysed thematically. RESULTS: Five focus groups were held with a total of 35 GP participants. Five themes developed, which illustrated that the study participants viewed the programme design as comprehensive and flexible. It has also been shown that participants' individual learning needs were addressed. Impacts of the programme on clinical practice included the following: confidence to care for patients who use AOD; confidence to collaborate with colleagues in delivery of AOD care; confidence to develop AOD professional networks in their community setting; and confidence to manage complex AOD presentations. CONCLUSION: Participants described the AOD programme as a high quality and positive educational experience. The prioritisation of core treatment skills (whole-person care and structured approaches to behavioural change) was a feature of the professional development programme. The AOD programme design is a practical model to implement for future AOD GP education and continuing professional development.