Brief Interventions For Alcohol Problems Research Articles

Preventive Care in the Emergency Department: Screening and Brief Intervention for Alcohol Problems in the Emergency Department: A Systematic Review

Objective: To systematically review the medical literature in order to determine the strength of the recommendation for screening and brief intervention (SBI) for alcohol‐related problems in the emergency department (ED) setting. Methods: The review followed the methodology of systematic reviews and was facilitated through the use of a structured template, a companion explanatory piece, and a grading and methodological scoring system based on published criteria for critical appraisal. The primary outcome measure was the prevention of mortality and morbidity secondary to alcohol‐related illnesses/injuries. The secondary outcome measures included: decreased consumption; fewer ED/outpatient visits and hospitalizations; a decrease in social consequences; and increased referrals for follow‐up and/or treatment. Three Medline searches as well as a search of the Cochrane Library were performed. Two team members reviewed the abstracts and selected pertinent articles. References were screened for additional pertinent articles. Results: Twenty‐seven articles were identified and reviewed, in addition to the 14 primary articles included in the 1996 U.S. Preventive Services Task Force Report. The study populations were diverse, including inpatient, outpatient, and college settings, with ages ranging from 12 to 70 years. Four studies were ED‐based and two included EDs as one of multiple sites. Thirty‐nine studies on SBI, 30 randomized controlled and nine cohort, were used to formulate the current recommendation. A positive effect of the intervention was demonstrated in 32 of these studies. Conclusions: The authors recommend that SBI for alcohol‐related problems in the ED be incorporated into clinical practice.

Preventive care in the emergency department: screening and brief intervention for alcohol problems in the emergency department: a systematic review.

To systematically review the medical literature in order to determine the strength of the recommendation for screening and brief intervention (SBI) for alcohol-related problems in the emergency department (ED) setting. The review followed the methodology of systematic reviews and was facilitated through the use of a structured template, a companion explanatory piece, and a grading and methodological scoring system based on published criteria for critical appraisal. The primary outcome measure was the prevention of mortality and morbidity secondary to alcohol-related illnesses/injuries. The secondary outcome measures included: decreased consumption; fewer ED/outpatient visits and hospitalizations; a decrease in social consequences; and increased referrals for follow-up and/or treatment. Three Medline searches as well as a search of the Cochrane Library were performed. Two team members reviewed the abstracts and selected pertinent articles. References were screened for additional pertinent articles. Twenty-seven articles were identified and reviewed, in addition to the 14 primary articles included in the 1996 U.S. Preventive Services Task Force Report. The study populations were diverse, including inpatient, outpatient, and college settings, with ages ranging from 12 to 70 years. Four studies were ED-based and two included EDs as one of multiple sites. Thirty-nine studies on SBI, 30 randomized controlled and nine cohort, were used to formulate the current recommendation. A positive effect of the intervention was demonstrated in 32 of these studies. The authors recommend that SBI for alcohol-related problems in the ED be incorporated into clinical practice.

Does a Brief Intervention for Alcohol Problems Help Trauma Patients?

Does a Brief Intervention for Alcohol Problems Help Trauma Patients?

Brief interventions for alcohol problems: a meta-analytic review of controlled investigations in treatment-seeking and non-treatment-seeking populations.

Brief interventions for alcohol use disorders have been the focus of considerable research. In this meta-analytic review, we considered studies comparing brief interventions with either control or extended treatment conditions. We calculated the effect sizes for multiple drinking-related outcomes at multiple follow-up points, and took into account the critical distinction between treatment-seeking and non-treatment-seeking samples. Most investigations fell into one of two types: those comparing brief interventions with control conditions in non-treatment-seeking samples (n = 34) and those comparing brief interventions with extended treatment in treatment-seeking samples (n = 20). For studies of the first type, small to medium aggregate effect sizes in favor of brief interventions emerged across different follow-up points. At follow-up after > 3-6 months, the effect for brief interventions compared to control conditions was significantly larger when individuals with more severe alcohol problems were excluded. For studies of the second type, the effect sizes were largely not significantly different from zero. This review summarizes additional positive evidence for brief interventions compared to control conditions typically delivered by health-care professionals to non-treatment-seeking samples. The results concur with previous reviews that found little difference between brief and extended treatment conditions. Because the evidence regarding brief interventions comes from different types of investigation with different samples, generalizations should be restricted to the populations, treatment characteristics and contexts represented in those studies.

Acceptability of emergency department-based screening and brief intervention for alcohol problems.

To adapt screening and brief intervention for alcohol problems (SBI) to a high-volume emergency department (ED) setting and evaluate its acceptability to patients. Patients at a large public-hospital ED were screened with the Alcohol Use Disorders Identification Test (AUDIT). Screen-positive drinkers (AUDIT score >/= 6) were provided brief, on-site counseling and referral as needed. Three months later, project staff blinded to baseline measures reassessed alcohol intake, alcohol-related harm, alcohol dependence symptoms, and readiness to change. Of 1, 034 patients approached, 78.3% (810) consented to participate (95% CI = 75.5% to 81.2%), and 21.2% (172) screened positive (95% CI = 18.4% to 24.0%). Of 88 patients with complete intervention data, 94.3% (83) accepted an intervention (95% CI = 89.5% to 99.2%), with acceptance rates ranging from 93% to 100% across four alcohol-problem-severity levels (p = 0.7). A majority (59.0%) set goals to decrease or stop drinking (95% CI = 48.4% to 69.6%). The group recontacted (n = 23) experienced statistically significant decreases in alcohol intake, alcohol-related harm, and dependence symptoms, with measures decreasing for 68%, 52%, and 61% of the patients. Readiness to change also showed statistically significant improvement, with scores increasing for 43% of the patients. Moreover, two-thirds of the patients (15/23) reported at follow-up that SBI was a helpful part of their ED visit. High rates of consent and acceptance of counseling for alcohol problems by patients across a wide range of problem severity indicate that this protocol was acceptable to at-risk patients in a public-hospital ED. Improvements in alcohol-related outcome measures at follow-up were strong enough to warrant controlled studies of intervention efficacy.

Making choices

Drug and Alcohol ReviewVolume 17, Issue 2 p. 149-152 Free Access Making choices John B. Saunders, John B. Saunders Editor Department of Psychiatry, University of Queensland, Brisbane, AustraliaSearch for more papers by this author John B. Saunders, John B. Saunders Editor Department of Psychiatry, University of Queensland, Brisbane, AustraliaSearch for more papers by this author First published: 29 May 2009 https://doi.org/10.1080/09595239800186941AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References 1 Edwards G., Anderson P., Babor TF et al. Alcohol policy and the public good. Oxford: Oxford University Press, 1994. 2 Saxena S. Alcohol, Europe and the developing countries, Addiction 1997; 92(Suppl.): 43– 8. 3 United Nations International Drug Control Programme. World Drug Report. New York: Oxford University Press, 1997. 4 World Health Organization. Amphetamine-type stimulants. Geneva: World Health Organization, 1997. 5 Single E., Rohl T. The National Drug Strategy: mapping the future. Canberra: Department of Health and Family Services, 1997. 6 Smart RG, Mann RE. Are increases in treatment levels and Alcoholics Anonymous membership large enough to reduce liver cirrhosis rates Br J Addict 1990; 85: 1291– 8. 7 Project MATCH Research Group, Matching alcoholism treatments to client heterogeneity: Project MATCH posttreatment drinking outcomes. J Stud Alcohol 1997; 58: 7– 29. 8 Bien TH, Miller WR, Tonigan JS. Brief interventions for alcohol problems: a review. Addiction 1993; 88: 315– 36. 9 Fagerstrom K-O. Measuring degree of physical dependency to tobacco smoking with reference to individualization of treatment. Addict Behav 1978; 3: 235– 41. 10 Saunders JB, Aasland OG, Babor TF, da la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption—II. Addiction 1993; 88: 791– 803. 11 WHO Brief Intervention Study Group. A cross-national trial of brief interventions with heavy drinkers. Am J Pub Health 1996; 86: 948– 55. 12 Holmila M. Experiences of Lahti project. Paper presented at the Kettil Bruun Society Symposium on Community Action Research, Chianti, Italy, September 1995. 13 Hawthorne G., Garrard J., Dunt D. Does Life Education's drug education programme have a public benefit Addiction 1995; 90: 205– 15. 14 Homel R. Random breath testing in Australia: a complex deterrent. Aust Drug Alc Rev 1988; 7: 231– 41. Volume17, Issue2June 1998Pages 149-152 ReferencesRelatedInformation

Outcome of brief intervention for alcohol problems in primary care: A critical review

Outcome of brief intervention for alcohol problems in primary care: A critical review

Primary health care and a public health approach to alcohol

AddictionVolume 89, Issue 6 p. 668-671 Free Access Primary health care and a public health approach to alcohol Peter Anderson, Peter Anderson c/o Prevention of Alcohol Abuse Programme, World Health Organization, Regional Office for Europe, 8 Scherfigsvej, Copenhagen 2100, Denmark.Search for more papers by this author Peter Anderson, Peter Anderson c/o Prevention of Alcohol Abuse Programme, World Health Organization, Regional Office for Europe, 8 Scherfigsvej, Copenhagen 2100, Denmark.Search for more papers by this author First published: June 1994 https://doi.org/10.1111/j.1360-0443.1994.tb00950.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References 1 Thom, B. & Tellez, C. (1986) A difficult business: detecting and managing alcohol problems in general practice, British Journal of Addiction, 81, pp. 405– 418. 2 Richmond, R. & Anderson, P. (1994) Research in general practice for smokers and excessive drinkers in Australia and the UK. I. Interpretation of the results, Addiction, 89, pp. 35– 40. 3 Richmond, R. & Anderson, P. (1994) Research in general practice for smokers and excessive drinkers in Australia and the UK. II. Representativeness of the results, Addiction, 89, pp. 41– 48. 4 Bien, T. H., Miller, W. R. & Scott Tonigan, J. (1993) Brief interventions for alcohol problems: a review, Addiction, 88, pp. 315– 335. 5 Saunders, J. B., Aasland, O. G., Amundsen, A. & Grant, M. (1993) Alcohol consumption and related problems among primary health care patients. WHO collaborative project on early detection of persons with harmful alcohol consumption–I, Addiction, 88, pp. 349– 362. 6 Saunders, J. B., Aasland, O. G., Babor, T. F., De LA Fuente, J. R. & Grant, M. (1993) Development of the Alcohol Use Disorders Identification Test (AUDIT). WHO collaborative project on early detection of persons with harmful alcohol consumption–II, Addiction, 88, pp. 791– 804. 7 Richmond, R. & Anderson, P. (1994) Research in general practice for smokers and excessive drinkers in Australia and the UK. III. Dissemination of interventions, Addiction, 89, pp. 49– 62. 8 Roche, A. M. & Richard, G. P. (1991) Doctors' willingness to intervene in patients' drug and alcohol problems, Social Science and Medicine, 33, pp. 1053– 1061. 9 Bracht, N. (1990) Health Promotion at the Community Level ( Newbury Park , California , Sage Publications). Citing Literature Volume89, Issue6June 1994Pages 668-671 ReferencesRelatedInformation

Brief interventions for alcohol problems: a review

Relatively brief interventions have consistently been found to be effective in reducing alcohol consumption or achieving treatment referral of problem drinkers. To date, the literature includes at least a dozen randomized trials of brief referral or retention procedures, and 32 controlled studies of brief interventions targeting drinking behavior, enrolling over 6000 problem drinkers in both health care and treatment settings across 14 nations. These studies indicate that brief interventions are more effective than no counseling, and often as effective as more extensive treatment. The outcome literature is reviewed, and common motivational elements of effective brief interventions are described. There is encouraging evidence that the course of harmful alcohol use can be effectively altered by well-designed intervention strategies which are feasible within relatively brief-contact contexts such as primary health care settings and employee assistance programs. Implications for future research and practice are considered.