Abstract
ObjectiveEstimate the effectiveness of brief interventions in reducing trauma recidivism in hospitalized trauma patients who screened positive for alcohol and/or illicit drug use.MethodsDynamic cohort study based on registry data from 1818 patients included in a screening and brief intervention program for alcohol and illicit drug use for hospitalized trauma patients. Three subcohorts emerged from the data analysis: patients who screened negative, those who screened positive and were offered brief intervention, and those who screened positive and were not offered brief intervention. Follow-up lasted from 10 to 52 months. Trauma-free survival, adjusted hazard rate ratios (aHRR) and adjusted incidence rate ratios (aIRR) were calculated, and complier average causal effect (CACE) analysis was used.ResultsWe found a higher cumulative risk of trauma recidivism in the subcohort who screened positive. In this subcohort, an aHRR of 0.63 (95% CI: 0.41–0.95) was obtained for the group offered brief intervention compared to the group not offered intervention. CACE analysis yielded an estimated 52% reduction in trauma recidivism associated with the brief intervention.ConclusionThe brief intervention offered during hospitalization in trauma patients positive for alcohol and/or illicit drug use can halve the incidence of trauma recidivism.
Highlights
Traumatic injury related to alcohol and illicit drug use remains an important public health challenge [1,2]
An adjusted hazard rate ratios (aHRR) of 0.63 was obtained for the group offered brief intervention compared to the group not offered intervention
complier average causal effect (CACE) analysis yielded an estimated 52% reduction in trauma recidivism associated with the brief intervention
Summary
Traumatic injury related to alcohol and illicit drug use remains an important public health challenge [1,2]. The use of screening, brief intervention, and referral to treatment (SBIRT) programs in trauma centers [8] is spreading as an evidence-based measure which may enhance the impact of preventive efforts in this population [9]. Brief intervention (BI) is a counseling approach based on the principles of motivational interviewing [10], a collaborative person-centered form of guidance intended to elicit and strengthen motivation for change [11]. Admission to trauma centers offers a potential “teachable moment” because patients may have perceptions of vulnerability about their health and may be receptive to screening and counseling [16]. There is evidence of the effectiveness of BI in reducing illegal drug consumption [22] or both alcohol and illicit drug use [23]
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