Background: Routine use of alcohol screening questionnaires is recommended in primary care, but patient beliefs and attitudes towards the acceptability of receiving alcohol enquiry from general practitioners (GPs) are unclear.
Methods: We searched medical databases to identify published empirical research on patient beliefs, attitudes and experiences towards receiving alcohol discussions from GPs. Coherent themes were synthesised from the results of the included studies using a realist perspective. Seventeen studies were included in the review – the majority were quantitative surveys from the UK, Nordic countries, North America and Australia.
Results and Discussion: GPs are seen to be legitimate providers of lifestyle advice, but patients may not find alcohol enquiry acceptable in a specific consultation. Alcohol discussions are less acceptable than those on other health promotion topics. The context of the consultation, such as the reason for presenting and the patient-doctor relationship, has an important influence on the situational acceptability of alcohol enquiry.
Conclusion: Although GP involvement in health promotion is perceived as legitimate, alcohol enquiry in consultations can be fraught and unwelcome. Contextual factors pertaining to the consultation appear to be important but these have not been well explored in the literature. Conclusions from this review should be restricted to societies with “Temperance” drinking cultures.