In order to assess whether screening and brief intervention could have an effect on people with alcohol use disorder (AUD), this study tested an extended brief intervention delivered in an emergency department. Patients were screened using the AUDIT; those with scores >15 were randomized to receive either a face-to-face intervention with a trained nurse while at the hospital (n=79), or to usual clinical care (n=81), which entailed “advice on alternative treatment options” only. Participants in the intervention group could then receive up to 5 additional sessions at 1–2 week intervals in an outpatient setting. Follow-up was at 3 and 6 months. The main outcome was reduction in DSM-IV alcohol dependence severity, measured with the Severity of Alcohol Dependence Questionnaire (SADQ) at 6 months. The mean number of sessions in the intervention group was 3 with a mean of 19.6 minutes per session. At 6 month follow-up:
- There was a reduction in both groups on the SADQ but no significant difference between groups (odds ratio, 1.02).
- There were no differences between groups in regards to the secondary outcomes (AUDIT score, alcohol use, readiness to change [measured with the Readiness to Change Questionnaire], and Leeds Dependency Questionnaire score).
Comments: Due to an imbalance between participants recruited before and after an internal pilot, the final analysis was restricted to participants recruited before the internal pilot. The study was therefore underpowered, but the measure of effect on the primary outcome suggests that the intervention was not superior to usual care. Clinically, treating AUD is important. Nevertheless, there is no evidence of efficacy for screening and brief intervention for patients with AUD over usual care.
Nicolas Bertholet, MD, MSc
Reference: Owens L, Kolamunnage-Dona R, Owens A, et al. A randomized controlled trial of extended brief intervention for alcohol-dependent patients in an acute hospital setting. Alcohol Alcohol. 2016;51(5):584–592.