The proportion of health care personnel reporting that they always or often queried their patients regarding alcohol use has increased significantly. This is particularly notable with nurses, where the proportion has doubled to 60 per cent, and midwives, where 92 per cent estimate their capacity to identify risk consumption as good or very good. That states a three-year follow up of the Swedish Risk Drinking Project, which surveyed physicians and nurses in primary, occupational, maternity, and child health care across the entire country.
Sweden has experienced rapid changes in alcohol consumption, likely due to the effect of entry into the European Union (EU). Once noted for its relatively low alcohol consumption, Sweden experienced a 30 per cent increase during its first decade of EU membership.
Considerable resources have been invested to break new ground in alcohol prevention and Sweden is among those nations which invest most resources per capita in this area. One such investment is the Risk Drinking Project, which started in 2004. Its objective is to ensure that queries about alcohol consumption are a natural element in the daily interactions between health care staff and patients, integrated in such a way that it reflects the importance of alcohol as a source of medical injuries and illnesses. The project addresses early, preventive measures (secondary prevention) rather than focusing on alcohol abuse or severe alcohol-related problems.
Despite the fact that research has established that brief alcohol interventions are effective, widespread implementation of alcohol preventive measures has been slow internationally as well as in Sweden. Learning from other closely related areas such as tobacco reduction, the Risk Drinking Project proposed that the most effective way forward would involve motivational interviewing (MI) techniques and offering advice in a way that is tailored to the daily work practices of physicians and nurses in health centres.
The implementation of the Risk Drinking Project has been thoroughly evaluated, resulting in several scientific papers and a dissertation thesis. Baseline measurements were carried out in 2006 and were repeated in 2009 by Linköping University, which specializes in implementation research. Preliminary 2009 results were published in September 2009.
Results from all sub-projects - targeting general practitioners (GPs), nurses and resident doctors training to become specialists in family medicine in primary health care, physicians and nurses in occupational health care, and nurses in maternity and child care - show that extensive and comprehensive training in MI and the use of screening techniques have taken place across the country in recent years.
The proportion of primary health care physicians who consider themselves sufficiently knowledgeable to discuss give advice on alcohol with patients has also increased strongly. Eight of ten GPs in the country now consider themselves "fairly" or "very" knowledgeable, compared with six out of ten GPs three years ago. However, the nurses in primary health care are the group with the most striking improvements. The proportion who state that they have fairly good or very good knowledge on giving advice on alcohol has doubled from 30 to 60 per cent.