Abstract

Background: screening and brief interventions (sBis) for alcohol use are effective butchallenging to implement in primary care settings. Universal screening is resource-intensive and may not align with general practitioners’ (GPs) perceived professional role.Pragmatic case finding (PcF), which integrates alcohol discussions into clinically relevantcontexts, may provide a feasible alternative to traditional sBi.

Aim: this study aimed to assess the feasibility and acceptability of tailored, theory-basededucational outreach visits (eOVs) to embed PcF in primary care, explore its influenceon professional practice in addressing alcohol, and examine changes in determinants ofGP behaviour pre- and post-implementation.

Design and setting: Four eOVs were delivered in GP clinics in stavanger and Oslo,Norway, involving 37 GPs and 22 support staff, to enhance GPs’ ability to managealcohol-related health problems.

Method: a mixed-methods feasibility study comprising semi-structured group interviewsand quantitative surveys. Group interviews explored GPs’ experiences, while theDeterminants of implementation Behaviour Questionnaire (DiBQ) assessed changes inknowledge, skills and intentions. Qualitative data were thematically analysed.Quantitative data were analysed using descriptive statistics.

Results: GPs (n = 10) perceived the eOVs as feasible and acceptable, preferring in-personover remote delivery. Key themes included greater awareness of alcohol’s healthimpacts, sustaining awareness of hidden cases, reducing stigma through normaliseddiscussions, and balancing motivation with the challenge of changing entrenchedhabits. survey findings (n = 19) showed a gradual, positive shift in GPs’ knowledge, skills,and goals to discuss alcohol.Conclusion: the eOVs were feasible and acceptable for embedding PcF in primarycare. they may strengthen GPs’ capacity to address alcohol in routine consultations, butfurther research is needed to assess fidelity, sustainability, and patient-level outcomes.

Trial registration number: clinicaltrials.gov iD: Nct04725552.