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. 2024 Jul 6;25(1):248.
doi: 10.1186/s12875-024-02508-z.

Adjusting the 15-method to Danish general practice: identification of barriers, facilitators, and user needs

Peter Næsborg Schøler  1   2   3 , Jens Søndergaard  4 , Sanne Rasmussen  4 , Anette Søgaard Nielsen  5   6   7
Affiliations

Adjusting the 15-method to Danish general practice: identification of barriers, facilitators, and user needs

Peter Næsborg Schøler et al. BMC Prim Care. .

Abstract

Background: The 15-method is an opportunistic screening and brief intervention tool for alcohol-related problems in primary healthcare. A Danish feasibility study of the 15-method indicated that adjustments were needed to improve its contextual fit to Danish general practice. This adjustment process was conducted in two parts. The first part focused on identifying barriers, facilitators, and user needs for addressing alcohol using the 15-method. The second part will address the identified barriers and user needs to finalize a Danish version of the method. This study reports on part one of the adjustment process.

Methods: Semi-structured individual interviews and focus group interviews with healthcare professionals (n = 8) and patients (n = 5) from general practice in Denmark. Data analysis was conducted using thematic content analysis. The results were condensed into two focus areas that will form the basis for user workshops in part two of the adjustment process.

Results: The main barriers for addressing alcohol using the 15-method were patients and healthcare professionals not having the same agenda, having difficulty opening a conversation on alcohol, and workflow in the practices. Main facilitators included high interpersonal skills, taking the patient's perspective, and good routines and interdisciplinary work. Suggested adjustments and additions to the method included digitalization, visual icebreakers, quotes and examples, and development of a quick guide. The identified focus areas for user workshops were Communication and Material, and Integration to Workflows.

Conclusion: Healthcare professionals found the opportunistic screening approach exemplified by the 15-method to be beneficial in identifying and addressing alcohol-related problems. They appreciate the method's structured framework that assists in presenting treatment options. Identified adjustment areas to the 15-method will lay the groundwork for future efforts to develop a finalized Danish version of the 15-method.

Keywords: Alcohol use disorder; Implementation science; Participatory research; Physician-patient relations; Primary healthcare; Screening and brief intervention.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The three steps of the 15-method Notes: Step 1 is embedded in already scheduled appointments and is not a stand-alone consultation. Step 2 can include blood sampling and clinical examination. Step 3 ranges from one to four consultations. The Alcohol Use Disorder Identification Test (AUDIT) and patient material can be given to the patient to complete between consultations (illustrated by arrows between the steps). Pharmacological treatment includes disulfiram, acamprosate, nalmefene, and naltrexone
Fig. 2
Fig. 2
Suggested adjustments and additions to the 15-method Notes: * refers to form, e.g. digitalization of specific tool like the Alcohol Use Disorder Identification Test. † refers to content, e.g. the tone of the written material
Fig. 3
Fig. 3
The relationships between identified themes of barriers and facilitators for addressing alcohol in relation to the 15-method in Danish general practice Notes: Synthesis of themes into focus areas for user workshops. Interview data from four interviews with five patients and eight healthcare professionals
See this image and copyright information in PMC

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