Objective: The aim of this study is to investigate the distribution of healthcare provided for patients with alcohol use disorders (AUD) among different treatment settings and to provide insight in the unmet needs in the treatment of AUDs.
Methods: A total of 462 clinicians, including psychiatrists, family physicians (FPs), general practitioners (GPs), and internists from six geographical regions of Turkey were interviewed face-to-face by using a structured interview that was specifically produced for the study in order to provide information about clinicians’ daily practices for patients with AUD. Data were presented in frequencies and student’s t-test was used for statistical significance with an alpha value set to.05.
Results: Sixty-two internists, 150 GPs, 50 FPs and 200 psychiatrists participated in the study. Half of the psychiatrists were working in a specific alcohol treatment unit (outpatient/inpatient or both). 34 psychiatrists were working in AMATEMs (group 1), 34 were working in a specific treatment unit with both out-/inpatient facilities (group 2) and 32 were working in an outpatient-specific treatment unit (group 3). In terms of number of patients with AUD treated per month, group 1 reported an average of 151 (out of 667 patients per month), group 2 reported 48 (out of 662) and group 3 reported 37 (out of 728) whereas internists reported an average of 3 and GPs reported 1 patient. General psychiatrists reported an average of 15 patients with AUD per month out of 636 patients. 47% of the patients seeking treatment were reported to be referred by another facility and 87% of those referred for treatment were reported to be referred by GPs followed by general psychiatrists. 77% of the patients were reported to be referred by general psychiatrists. 29% of the patients referred for treatment were reported to be hospitalized whereas 23% were reported to reject any treatment. 53% of the patients with AUD were reported to seek treatment of their own will. Group 2 reported a higher proportion of follow-up patients (p<0.05) compared to group 1 (73% vs. 62%, respectively). Group 1 reported the highest number of newly diagnosed patients (38% of all treated patients) seen in daily practice. In terms of treatment modality 71% of all patients were reported to be treated at an outpatient unit whereas 15% were reported to be hospitalized. 14% of the patients with AUD were reported to deny any treatment.
Conclusion: The findings of the current study suggest that patients with AUD are treated mainly by AMATEMs and specific treatment units and GPs and general psychiatrists are the primary sources for referral of these patients to specific units. It may also be concluded that although proportions of follow-up patients with AUD are generally high, specific treatment units with both in- and outpatient facilities are superior in terms of patient follow-up