Health Professionals and Patients' Perspectives on Barriers and Facilitators for the Implementation of the S3-Guideline on Screening, Diagnostics and Treatment of Alcohou-Related Disorders Comparison of Data from the Model Region Bremen and a Nationwide Online-Survey

Purpose Aim of the study was to investigate barriers and facilitators forthe implementation of the S3-guideline on screening, diagnostics and treatment of alcohol-related disorders to inform the development of context specific implementation strategies. Methods As part of the project "Implementation and Evaluation of the S3-Guideline on screening, diagnostics and treatment of alcohol-related disorders" (IMPELA), funded by the German Ministry of Health, we conducted a cross-sectional survey among health care professionals as well as persons suffering from alcohol use disorders and their relatives in the federal state Bremen. The questionnaire was developed by the study group and consisted of relevant barriers and facilitators for the implementation of the S3-guideline. For dissemination in Bremen, various strategies were applied (postal, face-toface, leaflets). In addition, the questionnaire was distributed online via mailing lists of all German associations who were involved in the guideline development. Results Data from 263 health care professionals were included in the analyses. Of those, 163 (62%) lived in the city of Bremen and 100 (38%) in otherfederal states. Mean age was 51.7 (Bremen) and 50.9 (otherfederal states), and they had about 22.8 (Bremen) or 23.7 years (other federal states) of work experience. The majority of the health professionals (62.2% Bremen; 50% otherfederal states) were physicians. A lack of knowledge regarding the guideline (65,6% Bremen; 44% other federal states) and a lack of time (68,7 % Bremen; 50 % other federal states) were seen as major barriers by the health professionals. More information for professionals (33,7% Bremen; 39% other federal states) and fact-sheets (34,9% Bremen; 38% other federal states) were regarded as important strategies facilitating guideline implementation. In addition, 94 persons suffering from alcohol use disorders/relatives were reached (57.7% male; age M = 44.7 years). Of those, 51 utilized substance abuse treatment before (54.3 %). Barriers to optimal patient care were seen in the fact that persons with alcohol use disorders do not seektreatment because theyfear consequences (n =51; 54%) or becausethey deny having alcohol problems (N =49, 52.1 %), as well as too long waiting time before treatment. Relevant facilitators were seen in screening beyond the health care system (n =44; 46.8%) and a better coordination between different treatment sectors. Conclusions Given the results of this study, specific facilitation strategies are needed in addition to the previous dissemination efforts in order to reach a guideline-adherent care for patients with alcohol use disorders.