A mixed-methods study of staff perspectives on the barriers and facilitators to the implementation of patient-reported routine outcome measures and feedback in alcohol and other drug treatment

IF 3 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review Pub Date : 2025-02-10 DOI:10.1111/dar.14007

Nina Pocuca, Gabrielle Campbell, Anthony Barnett, Alison K. Beck, Rhiannon Ellem, Catherine A. Quinn, Peter J. Kelly, Briony Larance, Amanda L. Baker, Jason P. Connor, John Marsden, Gary C. K. Chan, Luke Connelly, Sabrina Lenzen, Michael Farrell, Robert Stirling, Suzie Hudson, Leanne Hides

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引用次数: 0

Abstract

Introduction

Preliminary evidence supports the use of patient-reported outcome measures (PROM) and feedback for enhancing client outcomes in alcohol and other drug (AOD) treatment. However, successful implementation remains challenging. This mixed-methods study applied the Consolidated Framework for Implementation Research (CFIR) framework to examine inner setting and staff characteristics that act as barriers and facilitators to the implementation of PROMs in AOD treatment.

Methods

To understand CFIR-informed barriers and facilitators to implement PROMs in AOD treatment, qualitative interviews were conducted with N = 23 AOD counsellors. A separate quantitative survey was conducted with N = 108 AOD counsellors.

Results

Four qualitative themes emerged: (i) PROMs and feedback are valuable to AOD treatment; (ii) counsellor resistance towards PROMs and feedback is a barrier to successful implementation; (iii) competing interests and logistical issues are barriers to the implementation of PROMs and feedback; and (iv) PROMs are a burden to clients that may serve to disengage them from treatment. Survey results indicated a positive association between leadership support (CFIR inner setting construct) and counsellor knowledge and beliefs regarding PROMs and feedback (CFIR staff characteristics construct; β = 0.35, 95% CI [0.13, 0.60]). Findings demonstrated a positive association between available PROMs resources (CFIR inner setting construct) and both knowledge and beliefs regarding PROMs and feedback (β = 0.31, 95% CI [0.14, 0.48]) and self-efficacy to implement PROMs and feedback (CFIR staff characteristics construct; β = 0.18, 95% CI [0.04, 0.32]).

Discussion and Conclusions

Findings point to the critical need to adopt a whole-of-organisation approach to foster buy-in for PROMs and feedback to support successful implementation.

查看原文本刊更多论文

对工作人员关于在酒精和其他药物治疗中实施病人报告的常规结果措施和反馈的障碍和促进因素的观点进行混合方法研究。

初步证据支持在酒精和其他药物（AOD）治疗中使用患者报告的结果测量（PROM）和反馈来提高客户的结果。然而，成功的实施仍然具有挑战性。这项混合方法研究应用了实施研究的综合框架（CFIR）框架来检查内部环境和员工特征，这些环境和特征是在AOD治疗中实施PROMs的障碍和促进因素。方法：通过对23名AOD咨询师进行定性访谈，了解在AOD治疗中实施prom的cfr知情障碍和促进因素。对108名AOD咨询师进行了单独的定量调查。结果：出现了四个定性主题：(i) PROMs和反馈对AOD治疗有价值；（ii）辅导员对prom和反馈的抵制是成功实施的障碍；（iii）相互竞争的利益和后勤问题阻碍了prom的实施和反馈；（iv） prom对客户来说是一种负担，可能会使他们脱离治疗。调查结果显示，领导支持（CFIR内部设置结构）与咨询师对PROMs和反馈（CFIR员工特征结构）的知识和信念呈正相关；β = 0.35, 95% ci[0.13, 0.60])。研究结果表明，在职员工的绩效考核资源（CFIR内部环境结构）与绩效考核和反馈的知识和信念（β = 0.31, 95% CI[0.14, 0.48]）和绩效考核和反馈的自我效能（CFIR员工特征结构）呈正相关；β = 0.18, 95% ci[0.04, 0.32])。讨论和结论：研究结果指出，迫切需要采用一种全组织的方法来促进对prom的支持，并提供反馈以支持成功实施。

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来源期刊

Drug and alcohol review SUBSTANCE ABUSE-

CiteScore

4.80

自引率

10.50%

发文量

151

期刊介绍： Drug and Alcohol Review is an international meeting ground for the views, expertise and experience of all those involved in studying alcohol, tobacco and drug problems. Contributors to the Journal examine and report on alcohol and drug use from a wide range of clinical, biomedical, epidemiological, psychological and sociological perspectives. Drug and Alcohol Review particularly encourages the submission of papers which have a harm reduction perspective. However, all philosophies will find a place in the Journal: the principal criterion for publication of papers is their quality.