Background
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Enable healthcare staff and clinical information systems to identify patients at risk of alcohol misuse, and provide preventative and therapeutic interventions.
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Is relevant to public health and healthcare organisations to inform commissioning and delivery of preventative services and clinical audit of health promotion practices.
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Enables epidemiological and clinical research on alcohol consumption among patients in primary and secondary care.
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Enables patient-relevant information to be shared across the health and care system to improve coordination and continuity of care.
Methods
Results
Participants
Profession |
N
|
---|---|
Physician | 51 |
General practitioner | 7 |
Surgeon | 5 |
Academic | 4 |
Patient | 4 |
Public health specialist | 4 |
Midwife | 3 |
Allied health professional | 2 |
Data specialist | 2 |
Healthcare manager | 2 |
Homeopath | 2 |
Nurse | 2 |
System supplier | 2 |
Alcohol trainer and consultant | 1 |
Clinical informatician | 1 |
Dental consultant | 1 |
Dual Diagnosis Care Manager/Trainer | 1 |
Healthcare commissioner | 1 |
Paediatrician | 1 |
Pharmacist | 1 |
PhD student | 1 |
Psychiatrist | 1 |
Social enterprise founder | 1 |
Total | 100 |
Domain | Construct | Description |
---|---|---|
Intervention | Relative advantage | Evidence based and validated |
Standardised and consistent | ||
Facilitate screening and brief interventions | ||
Diagnostic, prognostic, and social information | ||
Prescribing – drug interactions with alcohol | ||
Early recognition of alcohol withdrawal | ||
Temporal trends in alcohol use | ||
Audit, needs assessment, and research | ||
Adaptability – core components | Brief and simple | |
User-friendly EHR interface | ||
Standard template | ||
Visual depiction of alcohol units | ||
Instant access to results and interpretation | ||
Frequency of recording is context dependent | ||
Lower AUDIT-C thresholds in pregnancy | ||
Age criteria | ||
Patient confidentiality | ||
Adaptability – adaptable periphery | Care pathways and support services | |
Link with mental health services | ||
Wide range of health settings and health professionals potentially involved | ||
Self-completion of alcohol screening | ||
Direct patient access to EHRs and personal health records | ||
Inclusion in summary care records | ||
Electronic prompts for clinicians | ||
Other considerations | Costs and resources | |
Piloting | ||
Inner setting | Implementation climate | Integration with routine processes |
Clinical judgement | ||
Administrative burden | ||
Implementation of EHRs | ||
Integration of clinical information systems across health services | ||
IT infrastructure and digital connectivity | ||
Data governance | ||
Automation of care pathways | ||
Alignment with clinical coding standards and information models | ||
Organisational support and clear policy | ||
Clinical leadership | ||
Perceived importance among clinicians | ||
Financial incentives | ||
Key performance indicators | ||
Readiness for implementation | Training healthcare staff | |
Implementation guide | ||
Access to EHRs | ||
Culture | Professional and cultural attitudes towards alcohol use | |
Perception of usual practice | ||
Normalise alcohol screening and brief interventions in practice | ||
Networks, communication, and structural factors | Communication of benefits and relevance to clinicians and patients | |
Sensitive and non-judgemental communication | ||
Clear information on care pathways and best practice | ||
Integration of alcohol and mental health services | ||
Outer setting | Patient needs and resources | Underreporting of alcohol use |
Stigma | ||
Poor understanding of alcohol units | ||
Confidentiality | ||
Consent for data sharing between healthcare providers | ||
Association with poor mental health | ||
Adverse implications for life insurance, driving, and employment | ||
Bias future clinical assessments | ||
External policies and incentives | Clinical guidelines | |
Alcohol health campaigns | ||
Low risk drinking guidelines | ||
Financial incentives | ||
Key performance indicators | ||
Labelling of alcohol units lacking | ||
Cosmopolitanism and peer pressure | Communication and data sharing between health services | |
Coordination and continuity of care | ||
Influence of peers in primary care |