Table 3 Pharmacist concerns about discussing alcohol as another drug in the mix with medication

… it's a really good idea … I do agree that it's something that … affects medicine experts … Just obviously it's just a bit difficult conversation to have … it’s something that, unfortunately, just gets put down as, like, social history rather than something that could and does affect a lot of other things … it’s only when it’s, sort of, too late … you’re looking at liver tests or looking at issues that have arisen from alcohol … it’s only then tackled … [but] it's quite a personal thing and quite a difficult conversation to have (6)

I think if you had the right confidence and the right communication skills for the consultations … I think even discussing with you … I may overlook the fact that I’ve talked about their drugs, I’ve talked about alcohol in the essence of healthy living but not realising that it does affect actually your medication. The only time people probably ask that, ‘I’m taking antibiotics, does it affect with the alcohol’? … If you put it in as one of the drugs, I think it would really help, personally myself, I think I’d probably use this now in my next one … [but] how to handle the conversation? … (7)

That’s an interesting idea … It is weird, isn’t it? [not thought of as a drug] … it’s just it’s so culturally accepted … It’s a challenging one to intervene on … to do just normal medication reviews on that level is a challenge in itself … So adding something extra on is almost like an extra challenge, but they could work together [alcohol and medication] (9)

It’s a drug, at the end of the day, it should be classed as a drug … [but] another awkward conversation … (5)

I can’t 100 per cent say that I would’ve thought about it [as a drug] so that will probably be something different to me to try and incorporate. Probably mainly because I’d be a bit more worried about, well what … what if the patient does tell me that they drink 50 units a week, what do I do then? So I like to be fore-armed with all the information of what to do next … where to refer people to if we do find something that’s not ideal … it’s probably just the phrases that you use rather than going down a tick list … I think once you’ve got used to your own style of questions and things … I think it’s just developing my own way of broaching it, so it doesn’t sound like it’s just a tick box (X3)