Abstract
BackgroundAlcohol dependence affects approximately 3% of the English population, and accounts for significant medical and psychiatric morbidity. Only 5.6% of alcohol-dependent individuals ever access specialist treatment and only a small percentage ever seek treatment. As people who are alcohol dependent are more likely to have experienced health problems leading to frequent attendance at acute hospitals it would seem both sensible and practical to ensure that this setting is utilised as a major access point for treatment, and to test the effectiveness of these treatments.Methods/DesignThis is a randomised controlled trial with a primary hypothesis that extended brief interventions (EBI) delivered to alcohol-dependent patients in a hospital setting by an Alcohol Specialist Nurse (ASN) will be effective when compared to usual care in reducing overall alcohol consumption and improving on the standard measures of alcohol dependence. Consecutive patients will be screened for alcohol misuse in the Emergency Department (ED) of a district general hospital. On identification of an alcohol-related problem, following informed written consent, we aim to randomize 130 patients per group. The ASN will discharge to usual clinical care all control group patients, and plan a programme of EBI for treatment group patients. Follow-up interview will be undertaken by a researcher blinded to the intervention at 12 and 24 weeks. The primary outcome measure is level of alcohol dependence as determined by the Severity of Alcohol Dependence Questionnaire (SADQ) score. Secondary outcome measures include; Alcohol Use Disorders Identification Test (AUDIT) score, quantity and frequency of alcohol consumption, health-related quality of life measures, service utilisation, and patient experience. The trial will also allow an assessment of the cost-effectiveness of EBI in an acute hospital setting. In addition, patient experience will be assessed using qualitative methods.DiscussionThis paper presents a protocol for a RCT of EBI delivered to alcohol dependent patients by an ASN within an ED. Importantly; the trial will also seek to understand patients' perceptions and experiences of being part of a RCT and of receiving this form of intervention.Trial registration numberISRCTN: ISRCTN78062794
Highlights
Alcohol dependence affects approximately 3% of the English population, and accounts for significant medical and psychiatric morbidity
This paper presents a protocol for a RCT of extended brief interventions (EBI) delivered to alcohol dependent patients by an Alcohol Specialist Nurse (ASN) within an Emergency Department (ED)
Prevalence of alcohol dependence in medical inpatients ranges from 3% to 47% [5,6]
Summary
Alcohol dependence affects approximately 3% of the English population, and accounts for significant medical and psychiatric morbidity. Alcohol is a factor in over 40 medical conditions that can lead to hospitalisation, which in 2010/11 accounted for 1.1 million hospital admissions in England, an increase of 12% compared with 2008/09 [2,3]. Treatment in acute settings would seem to be woefully inadequate, as in most cases alcohol dependent hospitalised patients are given pharmacological detoxification and, when stable, discharged into primary care without further treatment or support. This is a missed opportunity on several levels: early identification and treatment can reduce subsequent individual harm, and may prevent desease pregression, which will ultimatly reduce the overall burden of alcohol to society as a whole and the NHS in particular
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
