Aims: To identify the target group for brief alcohol intervention in primary health care and to compare the prevalence of heavy drinking in two different primary health care populations and the general population in the same geographical area.
Design: Drinking data were collected from outpatients of primary health care by a questionnaire containing the CAGE test and quantity-frequency alcohol consumption questions and from a sample of the general population by a telephone survey, including the CAGE. The index of heavy drinking was for men three, and for women two, affirmative answers in CAGE which though not specifically a consumption questionnaire is a good marker of heavy drinking.
Setting: Two different primary health care populations (primary health care clinic and occupational health care clinic) and the general population in a Finnish health care area.
Participants: Consecutive 1861 primary health care clinic and 2942 occupational health care clinic outpatients and 544 randomly selected adults in the general population, contacted by telephone.
Findings: The primary health care clinic patients drank significantly more per occasion than the patients of the occupational health care clinic (75 vs. 66 g. in men; 33 vs. 27 g. in women) and fewer times per week (0.8 vs. 0.9 in men; 0.5 vs. 0.6 in women). The patients in the primary health care clinic also reported drinking more per week (76 vs. 67 g. in men; 23 vs. 19 g. in women); among women the difference was significant. Among men the prevalences of heavy drinking in the primary health care clinic, occupational health care clinic and general population were 20%, 17% and 16%, respectively (p > or = 0.05). Among women the corresponding figures were 9%, 6% and 13% (p < 0.05).
Conclusions: The high prevalence of heavy drinking found in the study confirms the importance of brief intervention by general practitioners. The study also indicates that prevalence and drinking habits depend on the type of clinic and heavy drinkers in general may not be over-represented in primary health care. This study raises the question, especially among women, of how to reach and to provide health advice to those heavy drinkers who do not attend primary health care facilities.