Barriers to and Facilitators of Alcohol Use Disorder Pharmacotherapy in Primary Care: A Qualitative Study in Five VA Clinics

Journal of General Internal Medicine
Emily C WilliamsAlex H S Harris

Abstract

Three medications are FDA-approved and recommended for treating alcohol use disorders (AUD) but they are not offered to most patients with AUD. Primary care (PC) may be an optimal setting in which to offer and prescribe AUD medications, but multiple barriers are likely. This qualitative study used social marketing theory, a behavior change approach that employs business marketing techniques including "segmenting the market," to describe (1) barriers and facilitators to prescribing AUD medications in PC, and (2) beliefs of PC providers after they were segmented into groups more and less willing to prescribe AUD medications. Qualitative, interview-based study. Twenty-four providers from five VA PC clinics. Providers completed in-person semi-structured interviews, which were recorded, transcribed, and analyzed using social marketing theory and thematic analysis. Providers were divided into two groups based on consensus review. Barriers included lack of knowledge and experience, beliefs that medications cannot replace specialty addiction treatment, and alcohol-related stigma. Facilitators included training, support for prescribing, and behavioral staff to support follow-up. Providers more willing to prescribe viewed prescribing for...Continue Reading

References

May 20, 2003·Addiction·Tami L MarkScott Crosse
Sep 6, 2003·Drug and Alcohol Dependence·Tami L MarkXue Song
Sep 25, 2003·The American Journal on Addictions·Tami L MarkScott Crosse
Mar 11, 2004·JAMA : the Journal of the American Medical Association·Ali H MokdadJulie L Gerberding
Dec 15, 2004·The Milbank Quarterly·Trisha GreenhalghOlivia Kyriakidou
Oct 15, 2005·Journal of Studies on Alcohol. Supplement·Helen M PettinatiBruce J Rounsaville
Mar 10, 2006·Psychiatric Services : a Journal of the American Psychiatric Association·Patrick Corrigan, Betsy Gelb
May 4, 2006·JAMA : the Journal of the American Medical Association·Raymond F AntonUNKNOWN COMBINE Study Research Group
May 16, 2006·Addiction·Deborah A DawsonPatricia S Chou
May 20, 2006·BMJ : British Medical Journal·W Douglas Evans
Jul 25, 2006·Primary Care Companion to the Journal of Clinical Psychiatry·Bradford L FelkerScott Ober
Jun 26, 2007·Journal of Substance Abuse Treatment·A Thomas McLellan
Oct 11, 2007·JAMA : the Journal of the American Medical Association·Mark L Willenbring
Jun 17, 2008·Medical Decision Making : an International Journal of the Society for Medical Decision Making·W Douglas Evans, Lauren McCormack
Jan 17, 2009·Health Policy·Zoë Slote Morris, Peter John Clarkson
Jun 19, 2009·Medical Care·Emily CarrierNirav R Shah
Oct 13, 2009·Lancet·A Thomas McLellan
Oct 23, 2009·American Journal of Public Health·Katherine Lyon DanielDogan Eroğlu
Dec 17, 2009·The International Journal on Drug Policy·John F Kelly, Cassandra M Westerhoff
Mar 4, 2010·JAMA : the Journal of the American Medical Association·A Thomas McLellan
Apr 29, 2010·JAMA : the Journal of the American Medical Association·Eric B Larson, Robert Reid
Sep 17, 2010·The American Journal of Psychiatry·Bernice A PescosolidoBruce G Link
Dec 21, 2010·Alcohol and Alcoholism : International Journal of the Medical Council on Alcoholism·Georg SchomerusMatthias C Angermeyer
Jul 21, 2011·Current Psychiatry Reports·Elizabeth M OlivaAlex H S Harris
Mar 2, 2012·The New England Journal of Medicine·Michael J Barry, Susan Edgman-Levitan
Apr 19, 2012·JAMA : the Journal of the American Medical Association·Joe V SelbyLori Frank
May 3, 2012·Psychiatric Services : a Journal of the American Psychiatric Association·Alex H S HarrisJodie A Trafton
May 26, 2012·Journal of Psychopharmacology·A R Lingford-HughesUNKNOWN British Association for Psychopharmacology, Expert Reviewers Group
Jun 4, 2013·Substance Abuse Treatment, Prevention, and Policy·Meriam M JanssenHenk F L Garretsen
May 16, 2014·JAMA : the Journal of the American Medical Association·Katharine A Bradley, Daniel R Kivlahan
May 16, 2014·JAMA : the Journal of the American Medical Association·Daniel E JonasJames C Garbutt
Dec 24, 2015·The American Journal on Addictions·Chiao-Wen LanBrandon D L Marshall
Feb 10, 2016·Drug and Alcohol Dependence·Geetanjali ChanderMary E McCaul
Oct 4, 2016·Journal of Substance Abuse Treatment·Emily C WilliamsChristian S Hendershot

❮ Previous
Next ❯

Citations

Jan 27, 2018·Journal of General Internal Medicine·Carol K Bates
Aug 16, 2019·Journal of General Internal Medicine·Elizabeth C SaundersJennifer McNeely
Nov 24, 2019·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Shari RogalKevin L Kraemer
Aug 22, 2020·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Amy T EdmondsEmily C Williams
Mar 3, 2020·Frontiers in Psychiatry·Jarrod EhrieHenry R Kranzler
Aug 25, 2020·Implementation Science Communications·Madeline C FrostEmily C Williams
Feb 16, 2021·Scandinavian Journal of Primary Health Care·Sara Wallhed FinnMaria Jirwe
Jan 31, 2021·Journal of General Internal Medicine·Eden BernsteinMichael B Rothberg
Aug 10, 2020·Journal of Addiction Medicine·Anne C FernandezFrederic C Blow
Aug 28, 2021·International Journal of Environmental Research and Public Health·Fares QeadanKevin English

❮ Previous
Next ❯

Related Concepts

Related Feeds

Addiction

This feed focuses mechanisms underlying addiction and addictive behaviour including heroin and opium dependence, alcohol intoxication, gambling, and tobacco addiction.

Alcohol Use Disorder

Alcohol use disorder involves a pattern of alcohol consumption that includes compulsive use and a loss of control over intake of alcohol. The impact on physical health, socioeconomic factors, and psychiatric health is profound. Find the latest research on alcohol use disorder here.