BACKGROUND: Hazardous alcohol use increases the risk of hypertension but is underdetected in primary health care patients. Use of the biomarker phosphatidylethanol (PEth), which reflects the last two to three weeks of alcohol consumption, is increasing in Swedish primary health care, but studies from that context are scarce or missing.

AIM: Explore general practitioners' (GPs') experiences of using PEth to identify hazardous alcohol use in the context of managing hypertension.

DESIGN & SETTING: A qualitative study of GPs (n=12) experienced in using PEth in hypertension management who were recruited at Swedish primary health care centres in 2021.

METHOD: The GPs participated in five focus groups interviews. A questioning route was used. The interviews were audio recorded, transcribed verbatim, and analysed with inductive qualitative content analysis.

RESULTS: The overall theme I don't hesitate anymore reflects the disappearance of GPs' fear that the PEth result might upset the patient, as this rarely occurred and that the positive effects of PEth predominated in the findings. The theme is underpinned by four sub-themes: serving as an eyeopener, improving the dialogue, using with care, and learning by doing.

CONCLUSION: PEth is a useful tool that changed GPs' routines for addressing alcohol and identifying hazardous alcohol use in patients with hypertension managed in primary health care. The GPs advocated adopting PEth as a routine test in the treatment of hypertension. However, PEth needs to be used with care to maximise benefit and minimise harm.