Healthcare professionals' experiences in preparing patients for elective alcohol detoxification - a service-level qualitative case-study

BACKGROUND: Services for individuals severely physically dependent on alcohol, wishing to undergo detoxification are limited. This is partly due to a lack of evidence surrounding safe alcohol reduction advice.

OBJECTIVES: To summarize the practices from an elective alcohol detoxification service provided by Sandwell and West Birmingham NHS Trust (SWB) (Birmingham, United Kingdom) aimed at preparing high-risk individuals for detoxification.

METHODS: Semi-structured interviews were conducted with healthcare professionals working at the SWB elective detoxification service, representing a collective experience of 50+ years in the management of alcohol related presentations. A descriptive qualitative analysis approach was adopted.

RESULTS: Four categories of discourse were observed: 1) establishing a motivation to change, 2) the importance of an in-depth alcohol history, and 3) an individualized approach to patients, and 4) the role that readiness to change attitudes play in preparedness for detoxification. Practical advice relating to alcohol reduction included: consolidation of multiple beverages to fewer, 'measure and discard' techniques, and spacing out consumption/diluting beverages.

CONCLUSIONS: Core components to elective detoxification preparation were: 1) safety, 2) the requirement of an individualized approach and 3) a willingness to take ownership of recovery. The approaches discussed may help improve translation of alcohol detoxification services to those considered high-risk. The Standards for Reporting Qualitative Research framework was applied throughout.