Knowledge, Opinions, and Practice Patterns of Obstetrician-Gynecologists Regarding Their Patients' Use of Alcohol


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Abstract

Objective:To evaluate the evolution of fetal alcohol spectrum disorder prevention practices including awareness and use of recently published tools.Methods:Fellows of the American College of Obstetricians and Gynecologists were asked about their knowledge, opinions, and practice regarding alcohol-related care. Eight hundred obstetrician-gynecologists (ob-gyns) were selected; 48.1% returned the survey.Results:The majority (66.0%) indicated that occasional alcohol consumption is not safe during any period of pregnancy. There was no consensus when asked if alcohol's effect on fetal development is clear (46.9% thought it was clear and 45.9% did not). Most (82.2%) ask all pregnant patients about alcohol use only during patients' initial visit, whereas 10.6% ask during initial and subsequent visits. Most (78.5%) advise abstinence when pregnant women report alcohol use. When asked which validated alcohol risk screening tool they most commonly use with pregnant patients, 57.8% said they use no tool. Although 71.9% felt prepared to screen for risky or hazardous drinking, older ob-gyns indicated feeling significantly more unprepared than younger ob-gyns. “Patient denial or resistance to treatment” was the top issue affecting alcohol screening and “referral resources for patients with alcohol problems” was the resource needed most. Most ob-gyns were not aware of the National Institute on Alcohol Abuse and Alcoholism “Clinician's Guide” or the American College of Obstetricians and Gynecologists “Fetal Alcohol Spectrum Disorder Prevention Tool Kit.”Conclusions:There are few changes in the alcohol-related screening and treatment patterns of ob-gyns since 1999; although perceived barriers and needs have changed. Interventions, including referral resources and continuing medical education training, are warranted.

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