IJCM_231A: Barriers and Facilitators for Integrating Screening and Brief Intervention for Quitting Substance Use in Primary Care Settings

Abstract

Background: Substance Use disorders (SUD) are commonly encountered in general medical practice which include people of all ages and socioeconomic groups. In these circumstances, Screening and Brief Intervention (SBI) can be a useful tool for managing the disease burden in primary care setting. There is a need to investigate the hurdles and enablers that act as a catalyst for integrating Screening and Brief Intervention in primary health care practice Objectives: To explore the barriers and facilitators for implementing screening and brief intervention (SBI) for SUD at primary health care settings Methodology: A written informed consent was obtained from the subjects after briefing about the topic and interview was initiated with the help of an interview guide. The interview was recorded using an audio recorder. The discussion was written in the vernacular language and translated verbatim. Inductive thematic coding was applied to analyse the data Results: A total of 10 participants were interviewed which included four Medical Officers (MO), two Auxiliary Nurse Midwives (ANMS), one each Medical Social Worker (MSW), Tobacco Cessation Cell Consultant, Counsellor and substance user. Some challenges to integrating screening services included lack of manpower, hesitance to reveal substance use by women and identifying trained health care providers to seek assistance for quitting. Facilitators of Screening and brief intervention delivered at Primary Care level includes a favourable attitude of the health care provider, awareness among doctors about harmful effects of substance use and patients’ good rapport with field workers Conclusion: This study’s results point towards a multi-pronged approach like involvement and capacity building of different health care providers like Accredited Social Health Activist (ASHA), ANMs and MO along with encouraging community participation for integrating Screening and Brief Intervention in this setting.