Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey
Abstract Objective The study aimed to identify the missed opportunity for detection and management of alcohol use disorder by primary health care workers. Design A cross-sectional survey Setting Outpatient services in the six governmental primary health care facilities in Moshi district council in T...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | Substance Abuse Treatment, Prevention, and Policy |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13011-022-00479-x |
| _version_ | 1818158453113225216 |
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| author | Dorothy Mushi Candida Moshiro Charlotte Hanlon Joel M. Francis Solomon Teferra |
| author_facet | Dorothy Mushi Candida Moshiro Charlotte Hanlon Joel M. Francis Solomon Teferra |
| author_sort | Dorothy Mushi |
| collection | DOAJ |
| description | Abstract Objective The study aimed to identify the missed opportunity for detection and management of alcohol use disorder by primary health care workers. Design A cross-sectional survey Setting Outpatient services in the six governmental primary health care facilities in Moshi district council in Tanzania. Participants A total of 1604 adults were screened for alcohol use disorder (AUD) using the Alcohol Use Disorder Identification Test (AUDIT). Participants scoring 8 or above then provided details about their help-seeking behavior and barriers to seeking care. Participants’ records were reviewed to assess the screening and management of AUD. Results In the last 12 months, 60.7% reported alcohol use, and heavy episodic drinking (HED) was reported by 37.3%. AUD (AUDIT ≥ 8) was present in 23.9%. Males were more likely to have HED (aPR = 1.43;95% CI:1.3 to 1.4) or AUD (aPR = 2.9; 95% CI 1.9 to 4.2). Both HED and AUD increased with age. Only one participant (0.3%) had documented AUD screening and management. Only 5% of participants screening positive for AUD had sought help. Reasons for not seeking care were thinking that the problem would get better by itself (55.0%), wanting to handle the problem alone (42.0%), or not being bothered by the problem (40.0%). Conclusion While reported alcohol use, HED, and AUD are common among patients presenting to primary healthcare facilities in northern Tanzania, help-seeking behavior and detection are very low. Not screening for AUD in primary health care is a missed opportunity for early detection and management. There is an urgent need to develop interventions to increase the detection of AUD by health care providers, while also addressing help-seeking behavior and barriers to seeking care. |
| first_indexed | 2024-12-11T15:30:19Z |
| format | Article |
| id | doaj.art-8880e01bfc8a414dbdf7af9ecb51adae |
| institution | Directory Open Access Journal |
| issn | 1747-597X |
| language | English |
| last_indexed | 2024-12-11T15:30:19Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Substance Abuse Treatment, Prevention, and Policy |
| spelling | doaj.art-8880e01bfc8a414dbdf7af9ecb51adae2022-12-22T01:00:05ZengBMCSubstance Abuse Treatment, Prevention, and Policy1747-597X2022-07-0117111110.1186/s13011-022-00479-xMissed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional surveyDorothy Mushi0Candida Moshiro1Charlotte Hanlon2Joel M. Francis3Solomon Teferra4Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied SciencesDepartment of Epidemiology and Biostatistics Muhimbili, University of Health and Allied SciencesDepartment of Psychiatry and Mental Health, Muhimbili University of Health and Allied SciencesDepartment of Epidemiology and Biostatistics Muhimbili, University of Health and Allied SciencesDepartment of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa UniversityAbstract Objective The study aimed to identify the missed opportunity for detection and management of alcohol use disorder by primary health care workers. Design A cross-sectional survey Setting Outpatient services in the six governmental primary health care facilities in Moshi district council in Tanzania. Participants A total of 1604 adults were screened for alcohol use disorder (AUD) using the Alcohol Use Disorder Identification Test (AUDIT). Participants scoring 8 or above then provided details about their help-seeking behavior and barriers to seeking care. Participants’ records were reviewed to assess the screening and management of AUD. Results In the last 12 months, 60.7% reported alcohol use, and heavy episodic drinking (HED) was reported by 37.3%. AUD (AUDIT ≥ 8) was present in 23.9%. Males were more likely to have HED (aPR = 1.43;95% CI:1.3 to 1.4) or AUD (aPR = 2.9; 95% CI 1.9 to 4.2). Both HED and AUD increased with age. Only one participant (0.3%) had documented AUD screening and management. Only 5% of participants screening positive for AUD had sought help. Reasons for not seeking care were thinking that the problem would get better by itself (55.0%), wanting to handle the problem alone (42.0%), or not being bothered by the problem (40.0%). Conclusion While reported alcohol use, HED, and AUD are common among patients presenting to primary healthcare facilities in northern Tanzania, help-seeking behavior and detection are very low. Not screening for AUD in primary health care is a missed opportunity for early detection and management. There is an urgent need to develop interventions to increase the detection of AUD by health care providers, while also addressing help-seeking behavior and barriers to seeking care.https://doi.org/10.1186/s13011-022-00479-xAlcohol use disorderPrimary health careScreeningDetectionAlcohol use disorder managementHelp-seeking |
| spellingShingle | Dorothy Mushi Candida Moshiro Charlotte Hanlon Joel M. Francis Solomon Teferra Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey Substance Abuse Treatment, Prevention, and Policy Alcohol use disorder Primary health care Screening Detection Alcohol use disorder management Help-seeking |
| title | Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey |
| title_full | Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey |
| title_fullStr | Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey |
| title_full_unstemmed | Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey |
| title_short | Missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural Tanzania: a cross-sectional survey |
| title_sort | missed opportunity for alcohol use disorder screening and management in primary health care facilities in northern rural tanzania a cross sectional survey |
| topic | Alcohol use disorder Primary health care Screening Detection Alcohol use disorder management Help-seeking |
| url | https://doi.org/10.1186/s13011-022-00479-x |
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