Corrigendum: Barriers to Alcohol Screening Among Hypertensive Patients and the Role of Stigma: Lessons for the Implementation of Screening and Brief Interventions in European Primary Care Settings.

Aims 1. To quantify barriers to alcohol screening among hypertensive patients reported by primary healthcare professionals. 2. To examine whether education and screening frequency measures are associated with stigma-related barriers. Methods A web survey was conducted among 3081 primary healthcare professionals from France, Germany, Italy, Spain and the UK. Participants were asked about perceived barriers to alcohol screening as free-text response. The replies were independently categorized by two raters. Stigma-related barriers were predicted by logistic regressions with education, knowledge on alcohol as risk factor and frequency of alcohol screening. Results In France and Italy, almost half of the reported barriers were stigma-related, whereas time constraints were cited most commonly in Spain and the UK. In Germany, nearly half of respondents rated the importance of alcohol screening for hypertension as low. Perception that regular screening is inappropriate or associated with too much effort, beliefs that screening is unnecessary, and insufficient knowledge of screening tools were cited as further barriers. Professional education on alcohol use was consistently rated to be poorer than the equivalent education on hypertension, and only a minority of respondents perceived alcohol as important risk factor for hypertension. Stigma-related barriers could not be significantly predicted by education, knowledge or screening frequency in most models. Conclusions Overall, regular alcohol screening among hypertensive patients seems to be widely accepted, but further education (Germany) and structural support (Spain, UK) could contribute to increase screening rates. In France and Italy, screening uptake could be improved by addressing stigma. Short Summary Alcohol screening among hypertensive patients was largely accepted among general practitioners from five different European countries. Reported screening barriers varied between countries and included time constraints, stigma and underrated importance of alcohol. Results did not indicate a positive impact of education and screening frequency on perception of stigma as barrier to screening.

[1]  J. Rehm,et al.  Alcohol screening and alcohol interventions among patients with hypertension in primary health care: an empirical survey of German general practitioners , 2017 .

[2]  P. Corrigan,et al.  Developing a research agenda for understanding the stigma of addictions Part I: Lessons from the Mental Health Stigma Literature. , 2017, The American journal on addictions.

[3]  J. Rehm,et al.  The role of alcohol in the management of hypertension in patients in European primary health care practices – a survey in the largest European Union countries , 2016, BMC Family Practice.

[4]  Ashutosh Kumar Singh,et al.  Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 , 2016, Lancet.

[5]  J. Rehm,et al.  Identification of smokers, drinkers and risky drinkers by general practitioners. , 2015, Drug and alcohol dependence.

[6]  E. Meland,et al.  When general practitioners talk about Alcohol: Exploring facilitating and hampering factors for pragmatic case finding , 2015, Scandinavian journal of public health.

[7]  Franco Sassi,et al.  Tackling harmful alcohol use: economics and public health policy. , 2015 .

[8]  E. Scafato,et al.  Brief Interventions Implementation on Alcohol from the European Health Systems Perspective , 2014, Front. Psychiatry.

[9]  Zoltan Dienes,et al.  Using Bayes to get the most out of non-significant results , 2014, Front. Psychol..

[10]  E. Kaner,et al.  The Impact of Brief Alcohol Interventions in Primary Healthcare: A Systematic Review of Reviews , 2013, Alcohol and alcoholism.

[11]  G Gmel,et al.  Defining substance use disorders: do we really need more than heavy use? , 2013, Alcohol and alcoholism.

[12]  G. Farnbacher,et al.  Barrieren und Möglichkeiten in der Umsetzung von alkoholbezogenen Interventionen in der hausärztlichen Praxis , 2013, Suchttherapie.

[13]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[14]  Nicolas Rüsch,et al.  Challenging the public stigma of mental illness: a meta-analysis of outcome studies. , 2012, Psychiatric services.

[15]  Louise Signal,et al.  Addressing patient alcohol use: a view from general practice. , 2012, Journal of primary health care.

[16]  R. Ray,et al.  Global strategy to reduce the harmful use of alcohol , 2012 .

[17]  Mei Lan Fang,et al.  The effectiveness of interventions for reducing stigma related to substance use disorders: a systematic review , 2012, Addiction.

[18]  F. Braddick,et al.  Alcohol policy in Europe: evidence from AMPHORA. , 2012 .

[19]  E. Goyder,et al.  Barriers and facilitators to implementing screening and brief intervention for alcohol misuse: a systematic review of qualitative evidence. , 2011, Journal of public health.

[20]  M. Carta,et al.  The stigma of alcohol dependence compared with other mental disorders: a review of population studies. , 2011, Alcohol and alcoholism.

[21]  O. Aasland,et al.  Barriers to implementing screening and brief interventions in general practice: findings from a qualitative study in Norway. , 2011, Alcohol and alcoholism.

[22]  Bruce G. Link,et al.  Stigma and treatment for alcohol disorders in the United States. , 2010, American journal of epidemiology.

[23]  N. Heather,et al.  The research translation problem: Alcohol screening and brief intervention in primary care – Real world evidence supports theory , 2010 .

[24]  J. Rehm,et al.  Alcohol and hypertension: gender differences in dose-response relationships determined through systematic review and meta-analysis. , 2009, Addiction.

[25]  G. Hensing,et al.  Does gender matter? A vignette study of general practitioners' management skills in handling patients with alcohol-related problems. , 2009, Alcohol and alcoholism.

[26]  T. Babor,et al.  Brief intervention, three decades on , 2008 .

[27]  T. Greenfield,et al.  Alcohol measurement methodology in epidemiology: recent advances and opportunities. , 2008, Addiction.

[28]  A. Allamani.  Alcoholic Beverages, Gender and European Cultures , 2008, Substance use & misuse.

[29]  L. Kriston,et al.  The alcohol use disorders identification test for detecting at-risk drinking: a systematic review and meta-analysis. , 2007, Journal of studies on alcohol and drugs.

[30]  C. May,et al.  Still a difficult business? Negotiating alcohol-related problems in general practice consultations. , 2006, Social science & medicine.

[31]  P. Miller,et al.  Initial Steps Taken by Nine Primary Care Practices to Implement Alcohol Screening Guidelines with Hypertensive Patients , 2006, Substance Abuse.

[32]  C. May,et al.  Seeing through the glass darkly? A qualitative exploration of GPs' drinking and their alcohol intervention practices. , 2006, Family practice.

[33]  P. Bendtsen,et al.  Factors influencing GPs' decisions regarding screening for high alcohol consumption: a focus group study in Swedish primary care. , 2005, Public health.

[34]  Robin Room,et al.  Stigma, social inequality and alcohol and drug use. , 2005, Drug and alcohol review.

[35]  Jussi Kauhanen,et al.  Factors influencing inquiry about patients' alcohol consumption by primary health care physicians: qualitative semi-structured interview study. , 2003, Family practice.

[36]  K. Malterud,et al.  Screening and brief intervention for excessive alcohol use: qualitative interview study of the experiences of general practitioners , 2002, BMJ : British Medical Journal.