Prioritization of methods for assessing alcohol use in emergency room settings: findings from a qualitative study

Limited alcohol-related injury data in hospital settings globally underscore the need for routine monitoring to inform policy formulation for injury prevention, especially in addressing violence and road traffic injuries. COVID-19 and the related alcohol sales bans in South Africa in 2020-21 brought the impact of alcohol on trauma presenting to health facilities into sharp focus and highlighted the absence of practical, cost-effective, and accurate alcohol diagnostic tools in emergency rooms This qualitative study aims to identify valuable alcohol-related information for stakeholders to inform a validation study of alcohol diagnostics for injury-related trauma. We conducted five virtual focus group discussions (FGDs) with four groups of stakeholders: clinicians (n = 9), academics (n = 4), hospital and other operational staff (n = 6), and policymakers (n = 4). FGDs were audio recorded and transcribed verbatim. Coding and thematic analyses were conducted using NVivo version 12. Results highlighted the belief that alcohol places a burden on the healthcare system and plays a significant role in injury causation and mortality. Currently, robust alcohol assessment in emergency rooms is lacking. Despite acknowledging that quantified blood alcohol levels would not change acute clinical management, there was consensus regarding the need-to-know patients' alcohol usage to inform long-term management and broader public health objectives. Findings support plans to validate the efficacy of selected alcohol diagnostic tools in public hospital settings and to further test their feasibility and utility at a national level.