Feasibility of alcohol interventions in cardiology: a mixed methods study of clinician perspectives in Sweden.

Aim: This study aimed to explore clinicians' perspectives on the feasibility of implementing alcohol screening and brief interventions (SBI) in cardiology services.

Methods and results: We conducted a multi-site, exploratory-sequential mixed methods study. Themes from qualitative interviews were integrated with the Capability, Opportunity, Motivation (COM-B) framework during the design and analysis of a cross-sectional survey of cardiology clinicians across Sweden. We assessed perceived capability, opportunities, motivation, and overall perceived feasibility for SBI, and explored associations using ordinal logistic regression. Among 638 participants (mean age=43 years, 75% women), median perceived feasibility was 66.7%; Motivation for SBI was highest (68.8%), followed by perceived opportunities (66.6%) and capability (62.5%). Perceived feasibility was higher among doctors (OR=2.67, 95%CI=1.38-5.13) compared to assistant nurses and among outpatient clinicians (OR=1.75, 95%CI=1.14-2.70) compared to inpatient staff. Participants with specialist experience in arrhythmia (OR=1.82, 95%CI=1.01-3.28) and heart failure (OR=1.95, 95%CI=1.14-3.33) perceived SBI as particularly feasible. Integrated analysis indicated that clinicians perceive universal alcohol screening as important, and that opportunities for SBI exist in cardiology. Implementation barriers may include low competence with brief interventions and doubts about the reliability of self-reported alcohol use.

Conclusion: Findings suggest that the perceived feasibility of SBI varies according to clinicians' professional backgrounds and the clinical context. Doctors, outpatient staff, and those with specialist experience tended to perceive SBI as feasible and may be important stakeholders for implementation in cardiology. Effective strategies may include task sharing with assistant nurses and adapting training to clinical competencies and professional independence.