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Pragmatic approaches for addressing alcohol in general practice: Development of a tailored implementation intervention

INTRODUCTION: Alcohol consumption is a leading global risk factor for ill-health and premature death. Alcohol screening and brief interventions (SBI) delivered in primary care is effective at reducing alcohol consumption, but routine implementation remains problematic. Screening all patients for exc...

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Autores principales: Potthoff, Sebastian, O'Donnell, Amy Jane, Karlsen, Andrea Taksdal, Brendryen, Håvar, Lid, Torgeir Gilje
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012791/
https://www.ncbi.nlm.nih.gov/pubmed/36925895
http://dx.doi.org/10.3389/frhs.2022.940383
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author Potthoff, Sebastian
O'Donnell, Amy Jane
Karlsen, Andrea Taksdal
Brendryen, Håvar
Lid, Torgeir Gilje
author_facet Potthoff, Sebastian
O'Donnell, Amy Jane
Karlsen, Andrea Taksdal
Brendryen, Håvar
Lid, Torgeir Gilje
author_sort Potthoff, Sebastian
collection PubMed
description INTRODUCTION: Alcohol consumption is a leading global risk factor for ill-health and premature death. Alcohol screening and brief interventions (SBI) delivered in primary care is effective at reducing alcohol consumption, but routine implementation remains problematic. Screening all patients for excessive drinking (universal screening) is resource-intensive and may be at odds with general practitioners' (GPs') perceived professional role. This study aimed to develop a tailored, theory-based training intervention to strengthen GPs' ability to address alcohol and to manage alcohol-related health problems through a pragmatic approach based on clinical relevance. METHODS: A qualitative study design involving focus group interviews and a structured questionnaire for free text replies with GPs in Norway. Behavioral analysis assessed factors influencing delivery of SBI according to the ‘capability, opportunity, motivation and behavior' (COM-B) model to inform intervention development using the Behavior Change Wheel. Qualitative data were analyzed using framework analysis and an iterative approach was adopted to develop the training. RESULTS: A purposive sample of GPs attended the focus groups (n = 25) and completed the questionnaire (n = 55). Four areas required additional support including: understanding the link between alcohol use and health problems; opening up the conversation on alcohol use; addressing alcohol and dealing with obstacles; and following-up and maintaining change. Findings informed the development of a four-session interactive training intervention and a digital intervention for providing support for patients between consultations to address the identified needs. CONCLUSION: This work highlights the value of pragmatic, relevance-based clinical strategies, as opposed to universal screening approaches to addressing alcohol in primary care. A pragmatic approach is more in line with GPs existing sclinical skill set and holds the potential to improve widespread uptake and implementation of SBI in routine primary care.
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spelling pubmed-100127912023-03-15 Pragmatic approaches for addressing alcohol in general practice: Development of a tailored implementation intervention Potthoff, Sebastian O'Donnell, Amy Jane Karlsen, Andrea Taksdal Brendryen, Håvar Lid, Torgeir Gilje Front Health Serv Health Services INTRODUCTION: Alcohol consumption is a leading global risk factor for ill-health and premature death. Alcohol screening and brief interventions (SBI) delivered in primary care is effective at reducing alcohol consumption, but routine implementation remains problematic. Screening all patients for excessive drinking (universal screening) is resource-intensive and may be at odds with general practitioners' (GPs') perceived professional role. This study aimed to develop a tailored, theory-based training intervention to strengthen GPs' ability to address alcohol and to manage alcohol-related health problems through a pragmatic approach based on clinical relevance. METHODS: A qualitative study design involving focus group interviews and a structured questionnaire for free text replies with GPs in Norway. Behavioral analysis assessed factors influencing delivery of SBI according to the ‘capability, opportunity, motivation and behavior' (COM-B) model to inform intervention development using the Behavior Change Wheel. Qualitative data were analyzed using framework analysis and an iterative approach was adopted to develop the training. RESULTS: A purposive sample of GPs attended the focus groups (n = 25) and completed the questionnaire (n = 55). Four areas required additional support including: understanding the link between alcohol use and health problems; opening up the conversation on alcohol use; addressing alcohol and dealing with obstacles; and following-up and maintaining change. Findings informed the development of a four-session interactive training intervention and a digital intervention for providing support for patients between consultations to address the identified needs. CONCLUSION: This work highlights the value of pragmatic, relevance-based clinical strategies, as opposed to universal screening approaches to addressing alcohol in primary care. A pragmatic approach is more in line with GPs existing sclinical skill set and holds the potential to improve widespread uptake and implementation of SBI in routine primary care. Frontiers Media S.A. 2022-11-17 /pmc/articles/PMC10012791/ /pubmed/36925895 http://dx.doi.org/10.3389/frhs.2022.940383 Text en Copyright © 2022 Potthoff, O'Donnell, Karlsen, Brendryen and Lid. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Services
Potthoff, Sebastian
O'Donnell, Amy Jane
Karlsen, Andrea Taksdal
Brendryen, Håvar
Lid, Torgeir Gilje
Pragmatic approaches for addressing alcohol in general practice: Development of a tailored implementation intervention
title Pragmatic approaches for addressing alcohol in general practice: Development of a tailored implementation intervention
title_full Pragmatic approaches for addressing alcohol in general practice: Development of a tailored implementation intervention
title_fullStr Pragmatic approaches for addressing alcohol in general practice: Development of a tailored implementation intervention
title_full_unstemmed Pragmatic approaches for addressing alcohol in general practice: Development of a tailored implementation intervention
title_short Pragmatic approaches for addressing alcohol in general practice: Development of a tailored implementation intervention
title_sort pragmatic approaches for addressing alcohol in general practice: development of a tailored implementation intervention
topic Health Services
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012791/
https://www.ncbi.nlm.nih.gov/pubmed/36925895
http://dx.doi.org/10.3389/frhs.2022.940383
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