Blood test and patient reports provide different pictures of alcohol use
A blood test and questions about alcohol use identify partly different patients with hazardous alcohol use. This is shown in a Swedish study comparing phosphatidylethanol (PEth) test results with patients’ self-reports in primary care. The findings suggest that clinicians need to consider several sources of information together.
Identifying hazardous alcohol use can be challenging in primary care. One approach is to ask patients about their alcohol consumption and alcohol-related problems. Another is the blood-based biomarker phosphatidylethanol (PEth), which reflects alcohol consumption over the preceding weeks.
In the new study, researchers compared PEth levels with scores on the Alcohol Use Disorders Identification Test (AUDIT) and patients’ reported number of standard drinks per week. The analyses were based on health records from more than 11,000 primary care patients in Region Dalarna, Sweden.
“Our results show that the methods provide different parts of the picture. A PEth result needs to be interpreted alongside what the patient says about their alcohol use and any related problems,” says Viktor Månsson, psychologist and researcher at Region Dalarna, the Centre for Psychiatry Research and the Department of Clinical Neuroscience at Karolinska Institutet.
The methods identify different patients
Among patients who had both a PEth result and an AUDIT score, AUDIT identified hazardous alcohol use in 26.5 per cent, compared with 18.3 per cent identified by PEth. Some patients were identified by only one of the two methods. One reason is that PEth reflects recent consumption, whereas AUDIT also captures alcohol-related problems over the preceding 12 months.
A blood test can provide information that does not emerge from a conversation, but it does not show everything about a patient’s drinking patterns or alcohol-related harm. The researchers therefore argue that PEth results should be interpreted alongside patients’ self-reports and used to inform individualised clinical conversations.
Funding and conflicts of interest
The study was funded by the Division of Psychiatry and Habilitation Services at Region Dalarna, the Center for Clinical Research in Dalarna and Systembolaget’s Alcohol Research Council. According to the article, the funders had no role in the study design or the interpretation of the results. The authors report no conflicts of interest.
Publication
Månsson V, Hammarberg A, Guterstam J, LoMartire R. Identifying Hazardous Alcohol Use in Primary Care: Concordance Between Phosphatidylethanol and Self-Reports. The Annals of Family Medicine. 2026;24(5):413–421. doi:10.1370/afm.260100