Embedding brief interventions for alcohol in general practice: a study protocol for the REACH Project feasibility trial

BJGP Open. 2021 Aug 24;5(4):BJGPO.2021.0037. doi: 10.3399/BJGPO.2021.0037. Print 2021 Aug.

Abstract

Background: Alcohol is a major source of harm in Australia that disproportionately affects low-income communities. Alcohol brief interventions (ABIs) combine an assessment of a person's alcohol use with advice to reduce health risks. Despite their effectiveness, ABIs are not routinely performed by clinicians. This article presents a protocol for a feasibility trial of pragmatic implementation strategies and a new set of resources to support clinicians to complete ABIs in Australian general practices.

Aim: To explore the facilitators and barriers to increasing the uptake of ABIs in primary care, including acceptability, reach, adoption, fidelity, and sustainability.

Design & setting: A mixed-methods evaluation of the uptake of ABIs in general practice clinics serving low-income communities in Melbourne, Australia. The approach is informed by the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT).

Method: The implementation strategies and resources will be trialled in five general practices over 12 months. The primary outcome will be change in the proportion of adult patients with a complete alcohol history in their electronic medical records. Baseline data collection includes a practice survey to describe practice routines for ABIs and de-identified patient medical record data on completed alcohol histories (repeated at 3, 6, 9, and 12-months post-intervention). Survey and interview data will also be collected from clinicians, patients, and primary health network staff to assess acceptability and feasibility of the intervention.

Conclusion: The study will explore how the implementation strategies and resources can improve alcohol screening and management among low-income patients in general practice.

Keywords: alcohol use disorder; feasibility studies; general practice; low income population; primary health care.