Alcohol misuse in patients attending a defence force general medical clinic.

Bekker D, MBChB, MFamMed

Van Velden DP, MBChB, MPraxMed

Department of Family Medicine, University of Stellenbosch

Correspondence:

Dr D Bekker, 3 Grobler Street, Aurora Durbanville, 7550

Tel: 021-5902635, e-mail: [email protected]

Abstract

Aim: To determine the prevalence of alcohol misuse in adult patients attending a defence force general practice clinic.

Design: Descriptive cross-sectional survey.

Methods: The setting is a military sickbay situated in the Cape Town metropolitan area, South Africa. Participants included all adult patients (>=18 years) attending the clinic during a three week period midyear. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was completed by patients. Two direct alcohol consumption questions were added determining the total drinks per week as well as the maximum number of drinks per occasion.

Results: Of the 658 patients approached, 40 (6%) declined to fill in the questionnaire. 42% of the 618 patients surveyed were female and 58% were male with an average age of 41 years. The group consisted of 44% current defence force members, 25% retired defence force members, 22% medical dependents and 7% civilians. The overall rate of alcohol misuse according to the AUDIT-questionnaire was 13,27%. Among male patients, 20,6% scored as misusers of alcohol, compared with 2,7% among females. A much higher level of misuse was also found under younger age groups. 38,1% of male apprentices at the technical college and 40,0% of male current defence force members staying on the base scored 8 or more on the AUDIT. In the group scoring less than 8 on the AUDIT-questionnaire a further 9 patients reported drinking on average more than 14 drinks per week for males and more than 9 drinks per week for females. In this group (AUDIT-score <8) 76 patients reported maximum number of drinks per occasion of more than 4 for men and more than 3 for women. If these two questions are included the overall rate of alcohol misuse found was 26,05%.

Conclusion: The high rate of alcohol misuse found in this group of patients is need for concern. The overall rate of alcohol misuse was not found to be higher than what was found in other studies in South Africa as well as other countries. This study supports the implementation of screening and intervention strategies in general medical clinics in the defence force. SA Fam Pract 2003;45(2):10-15

Keywords: alcohol misuse; Alcohol Use Disorders Identification Test (AUDIT); general medical practice; defence force; prevalence

 

The impact of HIV/AIDS on doctors - a report on 2 years experience of a balint group in Cape Town.

Levenstein, S. BSc, MBChB, MFGP(SA)

Balint Group Members: Drs M Biersteker, K Cohen, I Grauls, P Mwilambane, MN Shahid, D Zieff

Facilitators: Drs S Levenstein and G Schwartz

Correspondence:

Dr S Levenstein, 163 Koeberg rd, Brooklyn, Cape Town, 7405

Tel: Work:021-511-6430, Fax;021-511-0356, Email:[email protected] 

Abstract:

Two years experience with a vocational trainee “Balint Group” is reported. A large proportion of the patients presented were HIV positive and some had active AIDS. These patients presented special difficulties for the young trainee doctors which are discussed. (Particularly the fact that most patients were similar in age to the doctors and that the illness involved sexuality and often violence). Illustrative case studies are described. It is concluded that trainee family physicians need special training to cope with the relationship issues that arise with such patients. It is suggested that Balint Groups are a suitable vehicle for such training. SA Fam Pract 2003;45(2):16-19

Keywords: Balint, HIV, AIDS, group therapy