Point-of-care ultrasound in Danish general practice following implementation of basic organizational structures: a repeated cross-sectional study

BACKGROUND: Point-of-care ultrasound (POCUS) can strengthen diagnostic decision-making in general practice, yet effective implementation strategies remain underexplored. This study explores POCUS implementation among Danish general practitioners (GPs), examining adoption, engagement with implementation support, and changes in capability, opportunity, and motivation, as conceptualized by the COM-B model. METHODS: This repeated cross-sectional study surveyed all Danish GPs in 2019 and 2024. Data were summarized descriptively, and changes since 2019 were assessed as percentage-point differences. Prevalence ratios examined associations between unfamiliarity with organizational support/basic structures for applying POCUS and non-use. RESULTS: In 2024, 1279 GPs (38.0%) responded, of whom 26.5% used POCUS, representing a 15-percentage-point rise since 2019. Most users had engaged with implementation-support initiatives or resources compared with fewer non-users. Motivation was generally high, but non-users expressed more concerns, particularly about GPs' ability to perform POCUS safely and about opportunities being limited by high workload and time constraints. Changes in attitudes since 2019 particularly related to greater perceived organizational support, stronger belief that POCUS enhances patient trust, and increased concern about tasks shifting from secondary care. Despite persisting barriers, 33.6% of non-users anticipated future adoption. CONCLUSIONS: POCUS dissemination is expanding in Danish general practice, supported by emerging organizational structures and evolving attitudes. Structured training and guidelines are consistent with greater capability, while financial barriers continue to limit opportunities. Motivation remains high, though concerns about competence and appropriateness indicate need for continuous education and research to promote proper POCUS use. While some skepticism persists, most recognize benefits for diagnostic accuracy and patient trust.