How Do People Who Frequently Attend Emergency Departments for Alcohol-Related Reasons Use, View, and Experience Specialist Addiction Services?

Abstract

Background: People who frequently attend emergency departments (EDs) for alcohol-related reasons, cost health systems greatly. Although specialist addiction services may be more appropriate for their needs, drinkers often experience barriers accessing specialist alcohol-related support. Objectives: This study explores how people who frequently attend EDs for alcohol-related reasons use, view, and experience specialist addiction services. Methods: We conducted semi-structured interviews with 30 individuals recruited from six EDs across London, United Kingdom. Data relating to participants' sociodemographic characteristics and service use were systematically coded using qualitative software, and analyzed following the Framework. Results: ED usage over the last 12 months was high, whereas current use of specialist addiction services was low. We found little evidence that structural barriers were preventing participants from attending specialist services; rather, participants seemed not to require help with their alcohol use. When asked what support they desired for their drinking, only 11/30 participants identified alcohol-specific treatment. More commonly, they wanted help relating to mental health problems; social contact; paid or voluntary work; housing-related issues; or gym access. Women were more likely to be receiving, and to have support from a specialist addiction service. Conclusions/Importance: People who frequently attended EDs for alcohol-related reasons expressed low levels of interest in, and motivation for, alcohol-specific treatment but desired broader psychosocial support. Case management and assertive outreach appear to be valuable models of service delivery for this population (particularly for men). However, further qualitative and quantitative research is now needed to verify these findings in different countries, regions, and health care systems.

Attempts to reduce alcohol intake and treatment needs among people with probable alcohol dependence in England: a general population survey

“…Poor treatment access amongst people with alcohol dependence has been observed in the UK and Europe within the last decade [8,9,20]. While reported motivation to seek alcohol related support has been low in the past [21], our findings outline a relatively large population of people with probable dependence that are motivated to change their drinking patterns and are making attempts to reduce or quit drinking with and without alcohol intervention and treatment. This highlights the potential to improve treatment uptake and promote health among those consuming alcohol at problematic levels through increased engagement.…”

“…These findings demonstrate that this population are using low-cost support resources but are also receiving the most attention from traditional alcohol treatment. Reasons for the high proportion of people with probable dependence not using alcohol resources to help cut down or quit drinking (over 25%) could be a combination of a lack of awareness of existing support and treatment, poor accessibility, and a preference to seek assistance with mental health problems, social contact and work-related problems [21].…”

Scheduled care—As a way of caring: A phenomenological study of being cared for when suffering from alcohol use disorders

“…Our findings support these assumptions and may explain the nurses’ need to focus and prioritise according to firmly established routines, hence failing to recognise patients’ existential needs. In addition, a qualitative study found that patients suffering from AUD who frequently attended emergency departments wanted psychosocial care to be more highly prioritised by healthcare workers (Parkman, Neale, Day, & Drummond, ). This corroborates our findings and Galvin and Todres () statements on essential aspects of humanising care.…”

Iterative categorisation (IC) (part 2): interpreting qualitative data

“…Parkman et al . [36], meanwhile, explored how people who frequently attend emergency departments for alcohol‐related reasons use, view and experience specialist addiction services. When themes from their descriptive analyses were analysed for similarities and differences, they found that women were more likely to be receiving, and to want, support from a specialist addiction service than men.…”