Emergency clinician-delivered screening and intervention for high-risk alcohol use: a qualitative analysis

To evaluate qualitative feedback from patients who received opportunistic screening and brief intervention for harmful alcohol use during an ED attendance; to evaluate emergency staff attitudes to performing alcohol screening and delivering opportunistic brief intervention; and to document process issues associated with the introduction of routine clinician-initiated opportunistic screening and training and administration of brief intervention.

Structured and semi-structured interviews with emergency staff and recipients of brief intervention.

Sixty-nine patients were interviewed 3 months after an ED attendance where they received emergency clinician-delivered brief intervention for high-risk alcohol use. Twenty-two (32%; 95% CI 21-43%) reported a positive effect of brief intervention on thoughts or behaviour, but 29% (95% CI 18-40%) felt the intervention was not relevant for them or could not recall it. Four people (6%; 95% CI 1-12%) felt confronted or embarrassed, and 17 (25%; 95% CI 15-36%) felt timing or delivery could be improved. Staff had a positive attitude to delivering brief intervention, but nominated lack of time as the main barrier. Fourteen of 15 staff felt brief intervention should become routine in emergency care.

Emergency clinicians can be trained to provide brief intervention for high-risk alcohol in an ED. The use of emergency clinician brief intervention is acceptable to most staff and patients.