Steensland Åsa, Segernäs Anna, Larsson Mårten, Johansson Capusan Andrea, Kastbom Lisa
Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Primary Health Care Centre Ekholmen, Linköping and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Scand J Prim Health Care. 2025 Jun;43(2):463-475. doi: 10.1080/02813432.2025.2456949. Epub 2025 Jan 29.
Alcohol use disorder (AUD) and hazardous alcohol use are common but underdiagnosed in primary health care (PHC). This study aimed to explore general practitioners' (GPs') experiences and perceptions of using B-Phosphatidylethanol (PEth), a specific quantitative biomarker for alcohol use, in their clinical work with patient consultations and treatment follow-up in Swedish PHC.
DESIGN, PARTICIPANTS, AND SETTING: Individual interviews were conducted with GPs and resident GPs (n 20) in Swedish PHC and analysed using qualitative content analysis.
The overarching theme illustrated that PEth testing has improved the prerequisites for the GP-patient interaction while making it more complex. Four categories underpinned this theme: , describing the challenges in the GP-patient interaction when hazardous alcohol use or AUD was suspected; , illustrating the struggle of integrating PEth testing into clinical practice and how it diminished the role of alcohol history taking; , comprising both the difficulties in informing about PEth testing and the positive impact on the interaction, and , emphasising the consequences of elevated PEth test results and their influence on physicians' motivation to using PEth.
PEth is an important tool in the identification of hazardous alcohol use. Emerging ethical dilemmas regarding patient information on PEth testing and management of medical and medico-legal obligations when test results indicate high alcohol use need to be addressed in future guidelines for clinical management of PEth.
酒精使用障碍（AUD）及危险饮酒在初级卫生保健（PHC）中很常见，但诊断不足。本研究旨在探讨瑞典初级卫生保健机构中全科医生（GPs）在患者咨询和治疗随访的临床工作中使用B - 磷脂酰乙醇（PEth，一种酒精使用的特定定量生物标志物）的经验和看法。
设计、参与者与研究背景：对瑞典初级卫生保健机构中的全科医生和住院全科医生（共20名）进行了个人访谈，并采用定性内容分析法进行分析。
总体主题表明，PEth检测改善了全科医生与患者互动的前提条件，但同时也使其更加复杂。该主题有四个类别支撑：一是描述怀疑存在危险饮酒或酒精使用障碍时全科医生与患者互动中的挑战；二是说明将PEth检测纳入临床实践的困难以及它如何削弱了饮酒史询问的作用；三是既包括告知PEth检测的困难，也包括其对互动的积极影响；四是强调PEth检测结果升高的后果及其对医生使用PEth积极性的影响。
PEth是识别危险饮酒的重要工具。未来关于PEth临床管理的指南需要解决在PEth检测方面患者信息以及检测结果表明高酒精使用时医疗和法医学义务管理方面出现的新的伦理困境。
