General practitioners'views of home detoxification

ENGLISH :
There is a growing movement towards community-based health care for the treatment and management of alcohol and drug problems across Australia. In spite of substantial evidence to support the clinical efficacy, cost-effectiveness, and the utility of home detoxification, it is not an activity that has been readily embraced by Australian General Practitioners (GPs). Thus, GPs' views on this issue are vital if there is to be any form of viable home detoxification programme for alcohol and/or other drugs. A qualitative study was undertaken to determine General Practitioners' views in regard to alcohol and drug home detoxification. A qualitative data collection method, focus groups, was used. Focus group participants were obtained from a maximum variation sampling technique. Twelve focus groups were conducted in rural and metropolitan Queensland Australia, over a four-month period. Fifty-two participants (43 general practitioners and 9 other health professionals, 20 females and 32 males). Mean age was 40.5 years (age range 19-70). Views about home detoxification were dependent on level of experience with substance abuse treatment. Over-whelmingly, GPs argued that for home detoxification to become viable, there would need to be a more responsive infrastructure, clear policy guidelines, training and more reasonable remuneration than currently exists. GPs require improved training in addiction and drug and alcohol problems. Revised remuneration schemes will facilitate better GP management of complex chronic problems such as addiction. Even though GPs' held quite negative views about alcohol and drug dependent patients there was a high level of willingness to become involved in their treatment and support. Although the clinical efficacy of home detox has been demonstrated GPs have understandably mixed views about their potential involvement. Improved training, support and resourcing is needed to substantially facilitate the expansion of GPs' role into this growing area of care. (Author's abstract.)