Overcoming barriers to implementation of routine alcohol screening and brief intervention in general practice

Abstract

Background: Despite its efficacy, alcohol screening and brief intervention (ASBI) has rarely been integrated into routine clinical practice. This study aims to identify strategies that tackle barriers to ASBI implementation in general practice by involving health professionals and prevention experts. Methods: A three-round online Delphi study among health professionals and prevention experts was carried out in the Netherlands. The first open-ended questionnaire (N=39) generated ideas about strategies to overcome barriers. In the second round (N=214), participants were asked to indicate how useful they considered each strategy. Items without consensus were systematically fed back (N=144) in round three. Results: Results show that participants consensually supported the usefulness of 62 strategies targeting the inner and outer setting of the general practice, as well as intervention and provider characteristics. Differences between groups were found between GPs and practice nurses on the one hand and prevention experts on the other hand. Conclusions: This explorative study identified a broad set of feasible strategies and paves the way for future research to experimentally test the identified strategies using multifaceted approaches.