Title

The impact of screening, brief intervention, and referral for treatment on emergency department patients' alcohol use

UMMS Affiliation

Department of Emergency Medicine

Date

12-18-2007

Document Type

Article

Medical Subject Headings

Adult; Age Distribution; Alcohol Drinking; Emergency Service, Hospital; Female; Follow-Up Studies; Humans; Interviews as Topic; Logistic Models; Male; Mass Screening; Outcome and Process Assessment (Health Care); Referral and Consultation; Sex Distribution; Socioeconomic Factors; United States

Disciplines

Emergency Medicine

Abstract

STUDY OBJECTIVE: We determine the impact of a screening, brief intervention, and referral for treatment (SBIRT) program in reducing alcohol consumption among emergency department (ED) patients.

METHODS: Patients drinking above National Institute of Alcohol Abuse and Alcoholism low-risk guidelines were recruited from 14 sites nationwide from April to August 2004. A quasiexperimental comparison group design was used in which control and intervention patients were recruited sequentially at each site. Control patients received a written handout. The intervention group received the handout and a brief intervention, the Brief Negotiated Interview, to reduce unhealthy alcohol use. Follow-up surveys were conducted at 3 months by telephone using an interactive voice response system.

RESULTS: Of 7,751 patients screened, 2,051 (26%) exceeded the low-risk limits set by National Institute of Alcohol Abuse and Alcoholism; 1,132 (55%) of eligible patients consented and were enrolled (581 control, 551 intervention). Six hundred ninety-nine (62%) completed a 3-month follow-up survey, using the interactive voice response system. At follow-up, patients receiving a Brief Negotiated Interview reported consuming 3.25 fewer drinks per week than controls (coefficient [B] -3.25; 95% confidence interval [CI] -5.76 to -0.75), and the maximum number of drinks per occasion among those receiving Brief Negotiated Interview was almost three quarters of a drink less than controls (B -0.72; 95% CI -1.42 to -0.02). At-risk drinkers (CAGE <2) appeared to benefit more from a Brief Negotiated Interview than dependent drinkers (CAGE >2). At 3-month follow-up, 37.2% of patients with CAGE less than 2 in the intervention group no longer exceeded National Institute of Alcohol Abuse and Alcoholism low-risk limits compared with 18.6% in the control group (delta 18.6%; 95% CI 11.5% to 25.6%).

CONCLUSION: SBIRT appears effective in the ED setting for reducing unhealthy drinking at 3 months.

Rights and Permissions

Citation: Ann Emerg Med. 2007 Dec;50(6):699-710, 710.e1-6. Epub 2007 Sep 17. Link to article on publisher's site

Comments

Edwin Boudreaux is an author on this paper as a member of Academic ED SBIRT Research Collaborative.

At the time of publication, Edwin Boudreaux was not yet affiliated with the University of Massachusetts Medical School.

Related Resources

Link to Article in PubMed

PubMed ID

17870206