Research project DR/60 (Research action DR)
Aims
Despite a diversified outpatient care offer, general practitioners (GPs) are seen as major players in detecting and managing problems related to substance abuse (illegal or not). Similarly, occupational physicians (OPs) are also expected to play a role in the field of addiction, as health and safety promoters in the workplace (collective bargaining convention Nr. 100). In Belgium little is known about resources and strategies used by these health professionals when they are faced with this issue, nor what their interest or attitude are in it.
To answer these questions, the purpose of the UP TO DATE research is to know 1) what the current demand is for care in the front line; 2) to what extent GPs and OPs are involved in this problem, and 3) what resources they are able to use for providing appropriate response to all types of requests for treatment of substance abuse. Other professionals from the addiction sector will also be interviewed to assess if they consider these physicians as a support, and if the role played by GPs is sufficiently valued.
Our starting point is to take into account physicians' behaviour vis-à-vis the substance addiction phenomenon (alcohol, illegal drugs, hypnotics and tranquilizers) rather than specific behaviours to each substance group. Surveys for both professions were constructed similarly, limited to the adult patient population (18-65 years) for the sake of symmetry of investigations in general practice and occupational health.
Programme
Work package 1: Epidemiology
The UP TO DATE consortium will analyse epidemiological data to be collected in the general population during the first half of 2013 by the "Sentinel GPs’ network" managed by the Scientific Institute of Public Health (IPH). The content will focus, on one hand, on alcohol, illegal drugs, hypnotics and tranquilizers abuse, and, on the other hand, on the employment status.
Work package 2: Literature review
A systematic literature review will be conducted focusing on international guidelines about:
• Screening and interventions on substance abuse among GPs and OPs;
• Models for referral and collaboration between GPs, OPs, and specialized centres.
Work packages 3 (GPs) and 4 (OPs): Attitudes and experiences of GPs and OPs in daily practice regarding substance abuse, screening, prevention and management
These two WPs aim at describing the field context of attitudes and experience regarding alcohol, illegal drugs, hypnotics and tranquilizers abuse in various professional settings in general practice and occupational health, both for physicians who manage substance abuse in daily practice (eventually within a network) as for those who don’t or do little.
A qualitative approach will be first used to obtain a broad and comprehensive understanding of the various opinions, through individual interviews and/or focus groups. To triangulate data from the qualitative study and/or to detect specific local problems, a quantitative questionnaire survey will be conducted with a representative sample of the two concerned medical specialties.
Work package 5: A mirrored view
The wishes and needs for collaboration improvement with GPs and OPs will be assessed among other actors of the domain (field associations, mental health institutions, employers and trade unions, consultants responsible for prevention and human resource management in companies, judicial and penal system). The nominal group technique will be used to rank priorities and qualitative analysis.
Work package 6: International comparison
Relevant experiences or programmes from abroad aiming at the improvement of GPs and/or OPs involvement in substance abuse management and that were evaluated will be sought from Internet and grey literature. This phase of the research will identify the most interesting projects and assess to what extent they could be applied to Belgium.
Work package 7: Valorisation
The last phase of this research is to submit its findings to GPs’ and Ops' stakeholders (academics, members of scientific associations, medical trade unions) with the aim to help the integration into daily practice.
We will use Large Scale Interventions methodology (LSI), which comprises a trajectory with stakeholders contributing to the change process in all stages and balance top-down and bottom-up decision making. Workshops will be organized, first for primary care and occupational health stakeholders separately, and then a specific workshop gathering them together will be dedicated to the needs and recommendations regarding their collaboration.
Up to Date : use of psychoactive substances in adults: Prevention and Treatment by general practitioners and Occupational physicians; DATa retriEval : final report Book I
Vanmeerbeek, Marc - Remmen, Roy - Van Casteren, Viviane ... et al. Brussels : Belgian Scientific Policy, 2015 (SP2621)
[To download]
Up to Date : use of psychoactive substances in adults: Prevention and Treatment by general practitioners and Occupational physicians; DATa retriEval : final report Book II
Vanmeerbeek, Marc - Remmen, Roy - Van Casteren, Viviane ... et al. Brussels : Belgian Scientific Policy, 2015 (SP2622)
[To download]
Up to Date : use of psychoactive substances in adults: Prevention and Treatment by general practitioners and Occupational physicians; DATa retriEval : samenvatting
Vanmeerbeek, Marc - Remmen, Roy - Van Casteren, Viviane ... et al. Brussel : Federaal Wetenschapsbeleid, 2015 (SP2623)
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Up to Date : use of psychoactive substances in adults: Prevention and Treatment by general practitioners and Occupational physicians; DATa retriEval : résumé
Vanmeerbeek, Marc - Remmen, Roy - Van Casteren, Viviane ... et al. Bruxelles : Politique scientifique fédérale, 2015 (SP2624)
[To download]
