Emergency clinician‐delivered screening and intervention for high‐risk alcohol use: A qualitative analysis

OBJECTIVES: 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. METHODS: Structured and semi-structured interviews with emergency staff and recipients of brief intervention. RESULTS: 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. CONCLUSION: 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.