A review of guidelines for collaboration in substance misuse management

Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium.
Occupational Medicine (Impact Factor: 1.03). 07/2013; 63(6). DOI: 10.1093/occmed/kqt089
Source: PubMed


Substance misuse among the working population results in increasing economic costs. General practitioners (GPs) and occupational physicians (OPs) can play a central role in detecting and managing substance misuse in the working population. Their collaboration could be critical in coordinating care, in facilitating rehabilitation and in reducing sickness absence.AimsTo search guidelines for evidence on collaboration between GPs and OPs in substance misuse detection and management in the working population.Methods
International guidelines regarding collaborative care for alcohol, illicit drug, hypnotic and tranquillizer misuse were identified by a systematic search in the Guidelines International Network and US National Guidelines Clearinghouse databases.ResultsIn total, 20 guidelines were considered of sufficient methodological quality, based on the criteria of the Appraisal of Guidelines for Research and Education II instrument. Only two guidelines reported on the OP's role in screening and intervention for alcohol misuse.Conclusions
There is a lack of guidance on the OP's role and on collaboration between GPs and OPs in this field. Further study is required on their respective roles in substance misuse management, the effectiveness of workplace interventions and the benefits of collaboration.

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Available from: Marc Vanmeerbeek, Nov 25, 2014
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    ABSTRACT: Objective: Aiming to enhance occupational physicians' (OPs) practice when dealing with employee substance abuse, this study analyzes the experiences of OPs to gain insight into the factors influencing their behavior. Methods: Semi-structured interviews were conducted and analyzed using Interpretative Phenomenological Analysis. Results: OPs act differently depending on the type of drug. Their approach was mainly determined by contextual factors and by their attitudes and skills. Many OPs want to invest in health promotion. Barriers such as lack of time and focus on periodic examinations often hamper both adequate prevention and the management of workers with substance abuse. Conclusions: The approach to substance abuse by OPs could be supported by initiatives both at the individual and the collective level. A facilitating work context seems to be particularly important in their commitment to alcohol- and drug-related issues at work.
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