Addressing alcohol in routine healthcare in Sweden—population-based surveys in 2010 and 2017

Background: The aim of the study was to compare how alcohol was addressed in routine healthcare practice in Sweden in 2010 and 2017, following the 2011 implementation of national drinking guidelines. Methods: Population-based cross-sectional surveys were conducted in 2010 and in 2017. Subjects were 3200 respondents in 2010 (response rate 54%) and 3000 respondents in 2017 (response rate 51%) in Sweden. Both the 2010 and 2017 surveys collected data on: socio-demographics; alcohol consumption; healthcare visits in the past 12 months and characteristics of alcohol conversations in healthcare (duration, contents, experience and effects). Results: It was significantly more likely that respondents had a conversation about alcohol in healthcare in 2017 than in 2010 (OR = 1.49; 95% CI = 1.27-1.75; P<0.001). Conversations about alcohol in the healthcare were mostly short (<4 min), both in 2010 and 2017. The alcohol conversations in 2017 included less information about alcohol's influence on health (P = 0.002) compared with 2010. The experience of the conversation about alcohol was perceived as less dramatic in 2017 than in 2010 (P = 0.038). Conclusions: The results suggest that conversations about alcohol were more embedded in routine healthcare practice in Sweden in 2017 than in 2010. This development has occurred since the 2011 publication of the national guidelines. Alcohol conversations targeted also specific groups of drinkers as recommended by the guidelines. However, our study design does not allow for conclusions about the relationship between the guidelines and the changes in healthcare practice.