[Prevalence and factors associated with clinical counselling on drug use among internal specialists residents of Andalusia (Spain)]

Aten Primaria. 2015 Dec;47(10):659-68. doi: 10.1016/j.aprim.2014.11.009. Epub 2015 Feb 20.
[Article in Spanish]

Abstract
in English, Spanish

Objectives: To determine the frequency of offering clinical counseling against the consumption of alcohol, tobacco and illegal drugs by internal specialist residents (EIR) of Andalusia, and the factors related to such advice.

Design: Multicenter cross-sectional study by self-administered questionnaire sent by mail.

Setting and participants: EIR of Andalusia.

Main measurements: The questionnaire collected the frequency of counseling against the use of alcohol, tobacco and illegal drugs (dependent variable).

Independent variables: age/gender, specialty, drug consumption and Fagerström test.

Results: Out of a total of 4245 participants, 66% responded, 29% did not respond, and 5% poorly completed questionnaires. The mean age was 29.1(±SD 5.1) years, 69% female, 89% Spanish nationality, 84% in medical training (73% hospital, 27% family medicine). The frequency of counseling against tobacco (85%) and alcohol (82%) is higher than illegal drugs (56%, p<.001, χ(2) test). Counseling against alcohol consumption is related to family medicine (OR=2.8; 95% CI [1.4-4.6]) and nursing (OR=2.5 [1.7-4.4]), and the age of first alcohol consumption (OR=1.07 [1.03-1.1]). Counseling against smoking is related to family medicine (OR=12.9;[7.6-21.9]) and nursing (OR=8.4;[4.3-16.5]), personal consumption of tobacco (OR=1.5 [1.2-2.0]), and wine (OR=1.1 [1.04-1.3]), and age of first alcohol consumption (OR=1.06 [1.01-1.1]). Counseling against illegal drugs is related to the age of first alcohol consumption (OR=1.09 [1.05-1.1]) and smoking (OR=.58 [.4-.7]).

Conclusion: There is a high frequency of counseling against consumption of tobacco and alcohol by EIR, although remarkably smaller for illegal drugs. The influencing factors are both formative elements of their own specialty such as personal consumption of alcohol and tobacco, which should be considered for improvement of this preventive activity.

Objetivos: Conocer la frecuencia de la oferta de consejo clínico contra el consumo de alcohol, tabaco y drogas ilegales por los especialistas internos residentes (EIR) y los factores relacionados con dicho consejo.

Diseño: Estudio multicéntrico transversal mediante encuesta autoadministrada.

Emplazamiento y participantes: EIR de Andalucía (España), mediante correo electrónico.

Mediciones principales: Consejo declarado contra alcohol, tabaco y drogas ilegales, mediante escala Likert categorizada como «frecuente»/«no frecuente». Variables independientes: edad/sexo, especialidad, país de origen y características del consumo de drogas. Análisis mediante regresión logística.

Resultados: Cuatro mil doscientos cuarenta y cinco participantes con el 66% de respuestas, 29% no respondedores y 5% mala cumplimentación; edad media 29,1 ± DE 5,1 años, 69% mujeres, 89% nacionalidad española, 84% con formación en medicina (hospitalaria 73%, medicina familiar 27%). El consejo frecuente contra tabaco (85%) y alcohol (82%) es superior al de drogas ilegales (56%; p < 0,001 test de Chi cuadrado). El consejo frecuente contra el alcohol se relaciona con la especialidad (medicina familiar: OR = 2,8, IC 95% [1,4-4,6]; enfermería: OR = 2,5 [1,7-4,4]) y la edad del primer consumo alcohólico (OR = 1,07; [1,03-1,1]). Para el tabaco hay relación con la especialidad (medicina familiar: OR = 12,9 [7,6-21,9]; enfermería: OR = 8,4, [4,3-16,5]), el tabaquismo (OR = 1,5 [1,2-2,0]) y edad del primer consumo alcohólico (OR = 1,06 [1,01-1,1]), más importante para el vino (OR = 1,1 [1,04-1,3]). Aconsejar contra drogas ilegales se relaciona con la edad del primer consumo alcohólico (OR = 1,09 [1,05-1,1]) y el tabaquismo (OR = 0,58 [0,4-0,7]).

Conclusión: Hay una alta oferta de consejo contra el consumo por los EIR, aunque llamativamente menor para drogas ilegales. Los factores que influyen son tanto elementos formativos de su propia especialidad como el consumo personal de alcohol y tabaco, que deben ser tenidos en cuenta para una mejora de esta actividad preventiva.

Keywords: Alcohol; Consejo; Counseling; Droga ilegal; Internado no médico; Internado y residencia; Internship and residency; Non-medical internship; Smoking; Street drugs; Tabaquismo.

MeSH terms

  • Adult
  • Alcohol Drinking
  • Counseling*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Prevalence
  • Smoking
  • Spain
  • Specialization
  • Substance-Related Disorders / therapy*
  • Surveys and Questionnaires
  • Young Adult