QuikFix: A Randomized Controlled Trial of Telephone-Based Motivational Interviewing Enhanced with Individualised Personality-Targeted Coping Skills Training for Young People with Alcohol-Related Injuries and Illnesses Accessing Emergency Services

Abstract

Background: Alcohol related visits to emergency departments (EDs) among young people present a unique opportunity for alcohol treatment. Brief interventions using motivational interviewing (MI) targeting alcohol consumption have been widely studied for young people in EDs, but effect sizes are modest. Yet, most existing studies have not adapted MI to the needs of young people or targeted individual patient factors to increase effectiveness, and the public health impact of MI. This study compared the efficacy of telephone-delivered Assessment Feedback/Information (AF/I), standard MI, and QuikFix MI enhanced with individualised personality-risk targeted coping skills training for reducing alcohol consumption and related problems in young people presenting to an ED or rest/recovery service with alcohol-related injuries or illnesses. Methods: This single-blind superiority trial randomized 398 young people (16-25 years), to one-session of AF/I, or two sessions of AF/I plus MI or QuikFix. Participants were assessed at baseline, 1, 3, 6 and 12 months on the primary outcomes of alcohol consumption and alcohol-related problems. Findings: Reductions in consumption and alcohol-related problems were seen across the sample at all post-baseline assessments. At 1 month, QuikFix had significantly greater reductions in total standard (10 gm ethanol) drinks than MI (β = -15.09, 95% CI = [-24.09, -6.09]). At 12 months, QuikFix had greater reductions in total standard drinks and drinking days than both MI (β=-14.51, 95% CI = [-23.77, -5.26] and β = -0.34, 95% CI = [-0.52, -0.16]) and AF/I (β = -21.87, 95% CI = [-30.95, -12.79] and β = - 0.44, 95% CI = [-0.62, -0.27]) and had fewer standard drinks per drinking day compared with AF/I (β = -1.83, 95% CI = [-3.22, -0.45]) but not MI (β = -1.09, 95% CI = [-2.50, 0.32]). No differential effects on alcohol-related problems were found, but all groups improved. Interpretation: QuikFix had stronger effects on the alcohol consumption of young ED or rest/recovery service attendees than AF/I or MI over 12 months. Trial Registration: registered ANZCTR ACTRN 12613000108718. Funding Statement: This project was funded by an Australian National Health and Medical Research Council (NHMRC) Project Grant (APP1044046). Leanne Hides and Susan Cotton are supported by NHMRC Senior Research Fellowships. Gary Chan is supported by a University of Queensland Research Fellowship. During the study Jason Connor was supported by a NHMRC Career Development Fellowship (APP1031909). Declaration of Interests: The authors declare they have no conflicts of interest. Ethics Approval Statement: Ethical approvals were obtained from the relevant university and hospital human research ethics committees. SPIRIT and CONSORT Guidelines were followed.