Abstract

Background

Brief interventions (BIs) delivered in primary care can reduce harmful alcohol consumption. Yet, clinicians do not routinely offer BIs to reduce harmful alcohol use.

Objective

We explored the perspectives of clinicians and patients about the use of alcohol BIs during consultations in Australian primary care.

Methods

Semi-structured interviews and focus groups (face-to-face and virtual) were undertaken with 34 general practitioners, eight practice nurses and 17 patients. Field notes were made from audio-recordings and themes were identified using a descriptive qualitative approach with the field notes as the point of data analysis.

Results

Participants identified barriers within the consultation, practice setting and wider healthcare system plus across the community which reduce the delivery of BIs in primary care including: Australian drinking norms; inconsistent public health messaging around alcohol harm; primary care not recognized as a place to go for help; community stigma towards alcohol use; practice team culture towards preventive health, including systems for recording alcohol histories; limitations of clinical software and current patient resources.

Conclusion

Multiple layers of the healthcare system influence the use of BIs in primary care. Identified facilitators for embedding BIs in primary care included: (i) raising community and clinician awareness of the health harms of alcohol, (ii) reinforcing a primary care culture that promotes prevention and, (iii) supportive resources to facilitate discussion about alcohol use and strategies to reduce intake. Alcohol BIs in primary care could be further supported by community public health messages about alcohol use.

中文翻译：

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患者和临床医生对影响澳大利亚初级保健中酒精简短干预措施的因素的看法：一项定性描述性研究

摘要

背景

在初级保健中提供的简短干预 (BI) 可以减少有害的酒精消费。然而，临床医生并不经常提供 BI 来减少有害的酒精使用。

客观的

我们探讨了在澳大利亚初级保健咨询期间临床医生和患者对酒精 BI 使用的看法。

方法

对 34 名全科医生、8 名执业护士和 17 名患者进行了半结构化访谈和焦点小组（面对面和虚拟）。现场笔记是根据录音制作的，主题是使用描述性的定性方法确定的，现场笔记是数据分析的重点。

结果

参与者确定了咨询、实践环境和更广泛的医疗保健系统以及整个社区中的障碍，这些障碍减少了初级保健中 BI 的提供，包括：澳大利亚饮酒规范；关于酒精危害的公共卫生信息不一致；初级保健不被认为是寻求帮助的地方；社区对饮酒的污名化；实践预防健康的团队文化，包括记录酒精历史的系统；临床软件和当前患者资源的限制。

结论

医疗保健系统的多个层次影响 BI 在初级保健中的使用。确定将 BI 嵌入初级保健的促进因素包括：(i) 提高社区和临床医生对酒精对健康危害的认识，(ii) 加强促进预防的初级保健文化，以及 (iii) 支持资源以促进有关酒精使用和减少摄入量的策略。关于酒精使用的社区公共卫生信息可以进一步支持初级保健中的酒精 BI。