Financial reimbursement - Irrelevant for GPs' readiness to implement brief intervention to reduce alcohol consumption? A cross-sectional vignette study.

Abstract BACKGROUND: General Practitioners' (GPs) readiness to implement screening and brief intervention (SBI) to treat patients with excessive alcohol consumption is low. Several studies identified crucial barriers such as insufficient financial reimbursement. In contrast to the barriers-account, we assume that low implementation readiness of GPs may be less attributed to external barriers but rather more so to inherent characteristics of SBI. To test our assumption, we conducted a vignette study assessing the GPs' readiness to implement SBI in comparison to a pharmacological intervention also designed for the treatment of excessive drinkers in relation to standard or above-standard financial reimbursement. According to our hypothesis GPs should be less ready to implement SBI regardless of financial reimbursement. METHODS: A convenience sample of GPs was recruited to answer the questionnaire. To assess the GPs' implementation readiness a 4-item 6-point Likert scale was developed and pretested. RESULTS: One hundred forty GPs completed the questionnaire. GPs were more ready to implement the pharmacological intervention than SBI, F (1,132)=27.58, p >.001 (main effect). We found no effect for financial reimbursement, F (1,132)=3.60, ns , and no interaction effect, F (1,132)=2.20, ns . CONCLUSIONS: Further research should investigate more thoroughly the crucial characteristics of SBI to initiate a modification process finally leading to more effective primary care dependency prevention.