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Are Brief Alcohol Interventions Adequately Embedded in UK Primary Care? A Qualitative Study Utilising Normalisation Process Theory

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  • Amy O’Donnell

    (Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AX, UK)

  • Eileen Kaner

    (Institute of Health and Society, Newcastle University, Newcastle upon Tyne NE2 4AX, UK)

Abstract

Despite substantial evidence for their effectiveness, the adoption of alcohol screening and brief interventions (ASBI) in routine primary care remains inconsistent. Financial incentive schemes were introduced in England between 2008 and 2015 to encourage their delivery. We used Normalisation Process Theory-informed interviews to understand the barriers and facilitators experienced by 14 general practitioners (GPs) as they implemented ASBI during this period. We found multiple factors shaped provision. GPs were broadly cognisant and supportive of preventative alcohol interventions (coherence) but this did not necessarily translate into personal investment in their delivery (cognitive participation). This lack of investment shaped how GPs operationalised such “work” in day-to-day practice (collective action), with ASBI mostly delegated to nurses, and GPs reverting to “business as usual” in their management and treatment of problem drinking (reflexive monitoring). We conclude there has been limited progress towards the goal of an effectively embedded preventative alcohol care pathway in English primary care. Future policy should consider screening strategies that prioritise patients with conditions with a recognised link with excessive alcohol consumption, and which promote more efficient identification of the most problematic drinkers. Improved GP training to build skills and awareness of evidence-based ASBI tools could also help embed best practice over time.

Suggested Citation

  • Amy O’Donnell & Eileen Kaner, 2017. "Are Brief Alcohol Interventions Adequately Embedded in UK Primary Care? A Qualitative Study Utilising Normalisation Process Theory," IJERPH, MDPI, vol. 14(4), pages 1-16, March.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:4:p:350-:d:94331
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    References listed on IDEAS

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    1. Ajzen, Icek, 1991. "The theory of planned behavior," Organizational Behavior and Human Decision Processes, Elsevier, vol. 50(2), pages 179-211, December.
    2. Peter Anderson & Eileen Kaner & Myrna Keurhorst & Preben Bendtsen & Ben Van Steenkiste & Jillian Reynolds & Lidia Segura & Marcin Wojnar & Karolina Kłoda & Kathryn Parkinson & Colin Drummond & Katarzy, 2017. "Attitudes and Learning through Practice Are Key to Delivering Brief Interventions for Heavy Drinking in Primary Health Care: Analyses from the ODHIN Five Country Cluster Randomized Factorial Trial," IJERPH, MDPI, vol. 14(2), pages 1-12, January.
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    1. Kerstin Bode & Peter Whittaker & Miriam Dressler & Yvonne Bauer & Haider Ali, 2022. "Pain Management Program in Cardiology: A Template for Application of Normalization Process Theory and Social Marketing to Implement a Change in Practice Quality Improvement," IJERPH, MDPI, vol. 19(9), pages 1-12, April.

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