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Table 5 Developmental Formative Evaluation: The Example of Pharmacotherapy for Alcohol Use Disorders (Section VI.B)

From: An introduction to implementation science for the non-specialist

Key Barriers Identified (Exemplar Quote)

Resulting Implementation Refinements

Lack of time: “I don’t have time for this. Patients are not coming in asking to address their alcohol use. I’d be lucky to have 5 min to discuss this.”

• Condense educational materials.

• Make materials available through link in computerized record provider will already have open.

• Present research demonstrating that brief conversations can reduce patient drinking levels.

Do not perceive current system as problematic: “The system works fine as it is. We have great substance use disorder folks to refer them to.”

• Data to demonstrate that majority of patients do not follow through on referrals.

• Education on patient perspective: Patients that are not comfortable going to “addiction” or “mental health” clinic may address alcohol use as part of overall plan for improving health.

Perceived lack of patient interest: “Patients are not going to be happy with me if I bring this up. They don’t want to talk about it.”

• Present patient interview results: Patients want more information and would accept this information from their primary care provider.

Lack of proficiency: “I was never trained to deal with addictions. This is not in my purview.”

• Comprehensive education and consultation from peer specialists.

• Stress impact of alcohol use on major diseases that they struggle to manage on a daily basis.