Through a convenience sampling approach, we performed 5 detailed needs analysis interviews of PCPs. We also asked interviewees about typical primary care practice to better understand current behavior so that interactive educational materials would be realistic. With respect to typical primary care practice, we found that most of the PCPs screen for current substance abuse, but over half do not screen for past substance abuse. Most participants only ask about substance abuse during the patient interview if the medical history screening question(s) were positive or if there is another red flag. The fact that followup questioning only happens in these situations underscores the need for the medical history questions to be sensitive and evidence-based.
Interviewees reviewed the early plans for the website to see if it met their needs and to identify further needs. Interviewees described a strong interest in information on: 1) reimbursement, 2) how to handle resistance from patients, especially when alcohol is the substance, 3) brief intervention, and 4) referral resources. They also noted a lack of a protocol for updating screening info for patients in ongoing care. The planned curriculum is a core course on each of the following: screening, brief intervention, and referral to treatment plus an advanced course addressing variations in patients or settings. The planned educational approach is live, standardized patient interviews via online chat.
Support among the interviewees for the planned curriculum including the method of providing online learning was high. All participants said they were likely or very likely to take a course on SBIRT. The need for a curriculum including evidenced-based recommendations and skills training in SBIRT is clear.