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Perceptions of Patients’ Alcohol Use and Related Problems Among Primary Care Professionals in Rio de Janeiro

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Abstract

Alcohol screening and brief intervention in primary care reduce harmful alcohol use but are rarely conducted in Brazil. This study describes health professionals’ perceptions of patients’ harmful alcohol use. A modified grounded theory approach drawing on purposive sampling was used to secure interviews from thirty-three primary care professionals between September and November 2018. Data analysis was iterative; initial coding was developed by the full research team and refined using formative and axial coding. Alcohol symptomology varied and professionals associated harmful alcohol use with patients’ economic hardship. Although health professionals rarely identified alcohol-related problems among their patients, when alcohol problems were identified, it was often through consultations about other symptoms. Compared to drug use, low to moderate alcohol use was not considered harmful, supported in part by a widespread acceptance of alcohol use. Brazil’s universal primary care system uses a collaborative care model to support integrated treatment of medical and mental health conditions, but alcohol screenings often occur only after problems manifest. Given limited early identification of harmful alcohol use in primary care, it is necessary to improve professionals’ training related to alcohol screening and brief intervention to reduce alcohol-related disability-adjusted life years.

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Acknowledgements

The authors thank the mental health and addictions staff within the city of Rio de Janeiro, area coordinators, managers, and the staff at the primary care health units in participating programmatic. The authors thank the Fulbright Commission, CAPES, UERJ, Coordinating Study Centers’ staff, and the following: Bianca Pereira de Souza, Adriana Teixeira dos Santos, Leandra Urena, Gabriella Souza Oliberia Freitas, and interviewers: Angela Machado da Silva, Alice Lopes do Amaral Menezes, and Natalia Lelou Fazzioni.

Funding

Fulbright Scholars Award and in-kind support from Universidade do Estado do Rio de Janeiro.

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Authors and Affiliations

  1. Department of Health Policy and Management, City University of New York’s Graduate School of Public Health and Health Policy, 55 West 125th Street, New York, NY, 10027, USA

    Sean J. Haley

  2. Interdisciplinary Research Laboratory On Primary Care, Universidade Do Estado Do Rio de Janeiro, Rua Manoel de Abreu 444 6th Floor - Maracanã, Rio de Janeiro, 20551-030, Brazil

    Renata Vargens, Ana Alice da Silva Sudré, Flavia Ferreira, Kali Alves, Vitor Aguiar Lobato de Carvalho, Daniel Storti Netto Puig, Karen Athié & Sandra Fortes

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  1. Sean J. Haley
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Correspondence to Sean J. Haley.

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Haley, S.J., Vargens, R., da Silva Sudré, A.A. et al. Perceptions of Patients’ Alcohol Use and Related Problems Among Primary Care Professionals in Rio de Janeiro. Int J Ment Health Addiction 21, 1139–1156 (2023). https://doi.org/10.1007/s11469-021-00648-2

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