Evidence for Effectiveness of Brief Alcohol Intervention in Hospitals

Brief counseling for alcohol problems is efficacious in primary care settings. However, few studies have tested its efficacy in hospitals, where alcohol use disorders are even more prevalent. Dutch researchers systematically reviewed the literature to summarize the results of relevant controlled trials of brief intervention conducted in general hospitals.

Researchers identified 8 studies that compared the effects of brief intervention to usual care in 1597 men and women. Two of the studies were conducted with hospital outpatients while 6 were with inpatients on orthopedics, medicine, and surgery services for various reasons (from elective to more urgent). Brief interventions ranged from education to simple advice to counseling (or a combination of these) and were associated with

• decreases in alcohol-related problems in 4 of 6 studies;
• decreases in consumption in only 1 study (which was of outpatients) of 7 studies;
• decreases in serum gamma-glutamyltransferase levels in 2 of 4 studies.

Comments:

The fact that any benefits were detected in these studies—given their diverse settings, intervention content, and subjects whose clinical conditions varied in nature and urgency—is impressive. It is also notable that the review did not include studies of hospital trauma centers, where intervention is known to be effective. Nonetheless, this review points out that universal screening and intervention for all general hospital inpatients may be effective, but the evidence is inconclusive.

Richard Saitz, MD,MPH

Reference:

Emmen MJ, Schippers GM, Bleijenberg G, et al. Effectiveness of opportunistic brief interventions for problem drinking in a general hospital setting: systematic review. BMJ. 2004;328(7435):318.
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