Abstract
BackgroundElectronic screening and brief intervention (e-SBI) is a promising alternative to screening and brief intervention by health-care providers, but its efficacy in the hospital outpatient setting, which serves a large proportion of the population, has not been established. The aim of this study is to estimate the effect of e-SBI in hospital outpatients with hazardous or harmful drinking.Methods/DesignThis randomized controlled trial will be conducted in the outpatient department of a large tertiary referral hospital in Newcastle (population 540,000), Australia. Some 772 adults with appointments at a broad range of medical and surgical outpatient clinics who score 5–9 inclusive on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) subscale will be randomly assigned in a 1:1 ratio to electronic alcohol screening alone (control) or to e-SBI. As randomization will be effected by computer, researchers and participants (who will be invited to participate in a study of alcohol use over time) will be blinded to group assignment. The primary analysis will be based on the intention-to-treat principle and compare weekly volume (grams of alcohol) and the full AUDIT score with a six-month reference period between the groups six months post randomization. Secondary outcomes, assessed six and 12 months after randomization, will include drinking frequency, typical occasion quantity, proportion who report binge drinking, proportion who report heavy drinking, and health-care utilization.DiscussionIf e-SBI is efficacious in outpatient settings, it offers the prospect of systematically and sustainably reaching a large number of hazardous and harmful drinkers, many of whom do not otherwise seek or receive help.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12612000905864.
Highlights
Electronic screening and brief intervention (e-SBI) is a promising alternative to screening and brief intervention by health-care providers, but its efficacy in the hospital outpatient setting, which serves a large proportion of the population, has not been established
Unhealthy alcohol use is third in the list of leading risk factors for premature deaths and disability globally [1], and one in five Australian adults consume alcohol at a level that elevates their risk of alcohol-related disease or injury over their lifetime [2]
Alcohol screening and brief intervention has been shown to reduce unhealthy alcohol consumption in primary care patients who are not dependent on alcohol [3], and “brief advice for hazardous drinking”, which refers to a level or pattern of alcohol consumption that increases the risk of harmful consequences for the drinker and others, is included as a “good buy” in the World Health Organization’s list of interventions to tackle noncommunicable disease risk factors [4]
Summary
Electronic screening and brief intervention (e-SBI) is a promising alternative to screening and brief intervention by health-care providers, but its efficacy in the hospital outpatient setting, which serves a large proportion of the population, has not been established. Alcohol screening and brief intervention has been shown to reduce unhealthy alcohol consumption in primary care patients who are not dependent on alcohol [3], and “brief advice for hazardous drinking”, which refers to a level or pattern of alcohol consumption that increases the risk of harmful consequences for the drinker and others, is included as a “good buy” in the World Health Organization’s list of interventions to tackle noncommunicable disease risk factors [4]. The efficacy of e-SBI for adults across the lifespan, who have a broad range of drinking patterns, has not been established
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