Home > Enhancing alcohol screening and brief intervention among people receiving opioid agonist treatment: qualitative study in primary care.

McCombe, Geoff and Henihan, Anne Marie and Klimas, Jan and Swan, Davina and Leahy, D and Anderson, Rolande and Bury, Gerard and Dunne, Colum and Keenan, Eamon and Meagher, David and O'Gorman, Clodagh SM and O'Toole, Tom and Saunders, Jean and Smyth, Bobby P and Lambert, John S and Kaner, Eileen and Cullen, Water (2016) Enhancing alcohol screening and brief intervention among people receiving opioid agonist treatment: qualitative study in primary care. Drugs and Alcohol Today , 16 , (4) , pp. 247-258.


Purpose – Problem alcohol use (PAU) is common and associated with considerable adverse outcomes among patients receiving opioid agonist treatment (OAT). The purpose of this paper is to describe a qualitative feasibility assessment of a primary care-based complex intervention to promote screening and brief intervention for PAU, which also aims to examine acceptability and potential effectiveness.

Design/methodology/approach – Semi-structured interviews were conducted with 14 patients and eight general practitioners (GPs) who had been purposively sampled from practices that had participated in the feasibility study. The interviews were transcribed verbatim and analysed thematically.

Findings – Six key themes were identified. While all GPs found the intervention informative and feasible, most considered it challenging to incorporate into practice. Barriers included time constraints, and overlooking and underestimating PAU among this cohort of patients. However, the intervention was considered potentially deliverable and acceptable in practice. Patients reported that (in the absence of the intervention) their use of alcohol was rarely discussed with their GP, and were reticent to initiate conversations on their alcohol use for fear of having their methadone dose reduced.

Research limitations/implications – Although a complex intervention to enhance alcohol screening and brief intervention among primary care patients attending for OAT is likely to be feasible and acceptable, time constraints and patients’ reticence to discuss alcohol as well as GPs underestimating patients’ alcohol problems is a barrier to consistent, regular and accurate screening by GPs. Future research by way of a definitive efficacy trial informed by the findings of this study and the Psychosocial INTerventions for Alcohol quantitative data is a priority.

Originality/value – To the best of the knowledge, this is the first qualitative study to examine the capability of primary care to address PAU among patients receiving OAT.

Item Type:Article
Date:2016
Page Range:pp. 247-258
Publisher:Pier Professional
Volume:16
Number:4
EndNote:View
Accession Number:HRB (Available)
Related URLs:
Subjects:B Substances > Alcohol
G Health and disease > Substance use disorder > Alcohol use
HJ Treatment method > Substance disorder treatment method > Substance replacement method (substitution)
HJ Treatment method > Psychosocial treatment method > Individual therapy > Brief intervention
J Health care, prevention and rehabilitation > Identification and screening > Identification and screening for substance use
J Health care, prevention and rehabilitation > Health care programme or facility > Community-based treatment (primary care)
T Demographic characteristics > Doctor
VA Geographic area > Europe > Ireland

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