Abstract
The objective of this paper is to present a qualitative study of introducing substance misuse screening using the Screening Brief Intervention and Referral to Treatment (SBIRT) model, in primary care in Abu Dhabi.
Substance misuse in the UAE is an increasing problem. However religious beliefs and fear of legal consequences have prevented this topic from being openly discussed, risk levels identified through screening and treatment options offered.
A controlled trial was undertaken which included a qualitative process study which is reported here. Qualitative interviews with primary care physicians from two intervention clinics were undertaken to explore their views, experiences and attitudes towards substance misuse management in their clinic. Physicians were trained on SBIRT and on the research project process and documentation. At completion of the project, 10 months after the training, physicians (n=17) were invited to participate in an interview to explore their experiences of training and implementation of SBIRT. Interviews were recorded and transcribed. Inductive thematic coding was applied.
In total, 11 physicians were interviewed and three main themes emerged: (1) The SBIRT screening project, (2) cultural issues and (3) patient follow-up. Findings revealed a general willingness toward the concept of screening and delivering brief interventions in primary care although increased workload and uncertainties about remuneration for the service may be a barrier to future implementation. There was a perceived problem of substance misuse that was not currently being met and a strong perception that patients were not willing to reveal substance use due cultural barriers and fear of police involvement. In conclusion this qualitative process evaluation provided essential insight into implementing SBIRT in the Middle East. In conclusion, despite physician willingness and a clinical need for a substance misuse care pathway, the reluctance among patients to admit to substance use in this culture needs to be addressed to enable successful implementation.
| Original language | English |
|---|---|
| Pages (from-to) | 344-354 |
| Number of pages | 11 |
| Journal | Primary Health Care Research and Development |
| Volume | 19 |
| Issue number | 4 |
| Early online date | 26 Dec 2017 |
| DOIs | |
| Publication status | Published - 31 Jul 2018 |
Bibliographical note
Acknowledgements: The authors thank the primary care physicians for participating in this project which was novel and challenging for the UAE where research in primary care in rare.Financial Support: A.B., A.A., A.E.K. and H.A.G. were employed at the NRC who also funded the study. However, these authors did not input into the analysis or interpretation of results.
Conflicts of Interest: There are no conflicts of interest for authors C.M., C.M.B., C.P.-S. and A.J.L.
Ethical Standards: The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional guidelines on human experimentation (National Rehabilitation Centre, United Arab Emirates and University of Aberdeen, Division of Applied Health Sciences) and with the Helsinki Declaration of 1975, as revised in 2008.
Keywords
- Journal Article
- implementation
- Middle East
- primary care
- qualitative
- SBIRT
- substance use