Family medicine research assistants' knowledge and attitudes about alcohol and substance use disorders

Objectives: Alcohol and substance use disorders are major public health problems all over the world and effects mostly developing countries as our country. Dependence can be largely prevented by identification of risky users and brief interventions in primary care. This study was conducted to determine the knowledge and attitude about alcohol and substance use disorders among family medicine trainees who works in training and research hospitals located in the city center of Ankara. Methods: 144 Family Medicine trainees who works in Ankara Atatürk Training and Research Hospital, Ankara Numune Training and Research Hospital, Keçiören Training and Research Hospital, Dışkapı Training and Research Hospital and Ankara Training and Research Hospital were included to our study. A survey which consists of 37 questions has been applied to the physicians in order to assess their knowledge and attitude about alcohol and substance use disorders. The data which obtained from the survey were analyzed using SPSS for Windows v.20 software package. For examining the differences between the groups in quantitative data, Kruskal –Wallis, Pearson, Student T, One Way Anova, Mann Withney-U, Spearman tests were used. The results are interpreted as the level of significance; p <0,05. Results: 61.1% (n=88) of the 144 physicians participated in the study were female, 38.9% (n=56) were male. 91.7% (n=132) of physicians participated in the study had worked at another institution before working as a trainee whereas 8.3% (n=12) of them hadn't worked in any institution. According to their declaration, 28.4% (n=41) of the trainees had daily 21-40 patients, 25.6% (n=37) had daily 41-60 patients, 27.7% (n = 40) had daily 61-80 patients on average. 12% of physicians (n=17) said that they have previously worked in an addiction center. The frequency of encounters with alcohol and substance use disorder patients were 3-4 times per year in 45,8%(n=66) of physicians and 3-4 times per month in 30,6 %(n=44) of physicians. The ratio of physicians who frequently asks their patient about smoking was 49% (n=70) whereas the same ratio for alcohol consumption was 26% (n=38) and 17% (n=24) for substance use. %25 (n=36) of physicians declared that they could diagnose alcohol and substance use disorders according to the ICD-10 diagnostic criteria, on the other hand 75% (n=108) of them specified that they could not. The mean level of correct answers was 50 (Min:6,25 Max:81,25) over 100 for the questions of knowledge about alcohol and substance use disorders. In our study, knowledge related to alcohol and substance abuse disorders among physicians were compared with age groups and the difference of information level about alcohol and substance abuse disorders between age groups was statistically significant (p=0,04). Physicians in the 31-35 age range were behind the physicians in the 36-40 age range in terms of knowledge level about alcohol and substance use disorders. In our study, the physicians who worked in the addiction center were found to be more informed than the others who did not worked in these centers in terms of alcohol and substance use disorders. Conclusion: In order to take an active role of family physicians about alcohol and substance use disorders, they must have sufficient knowledge about this subject first. To achieve this, skill-based, comprehensive training should take place in Medical Faculty curriculum about the alcohol and substance use disorders. These trainings should be continuous trainings and supported by after graduation and in-service trainings. In the application for any reason, patients who abuse alcohol and substance should be identified at admission, risky drinking levels should be determined, if there is any related organic pathology, therapy should be organized or treatment should be regulated by relevant departments consulted. Nearly three out of every four people with substance abuse, has been shown to begin substance use under twenty years of age. The family physician should recognize adolescent population who accepted as risk group for substance abuse and it is important to recognize changes which may occur at an early stage. Family physicians should have the knowledge and skills to provide protective services for its own population about alcohol and substance use disorders. Family physicians should also take the history of substance use, should know the screening questions, be able to communicate with dependent patients and their relatives, should refer the patient to treatment and must be able to follow the patient. Keywords: Alcohol, Substance, Dependence, Family Medicine, Survey