Study Does Not Confirm Brief Intervention’s Efficacy
Systematic reviews find that screening and brief intervention, at least in primary care settings, can decrease drinking in people with nondependent unhealthy alcohol use. Brief intervention has also shown promise in emergency departments, trauma centers, and other hospital services, where many patients may be receptive to advice.
To assess brief intervention’s efficacy in trauma centers, researchers studied 187 adults (out of 4618 screened) who were hospitalized at two Level I Trauma Centers for traumatic vehicular injures and had a blood alcohol concentration (BAC) of >=10 mg/dL. Patients with a BAC <=10 mg/dL, signs of alcohol dependence, or who drank >12 standard drinks a day were excluded.
Subjects, who had an average age of 29 years, were randomized to receive one of the following:
- a 20-minute health interview only (control)
- a health interview and 5 minutes of simple advice
- a health interview, 5 minutes of advice, and two 20-minute brief counseling sessions
Twelve months later (43% loss to follow-up), alcohol consumption and traffic citations significantly decreased. However, there were no significant differences between the 3 groups.
The improvements seen in these patients after trauma hospitalization were not attributable to brief intervention but may reflect natural history or result from participation in a controlled trial that included alcohol and health assessments. Currently, Level I trauma centers must provide alcohol screening and brief intervention to receive accreditation. Given that resources are limited, how best to deploy this important service will require further study.Richard Saitz, MD, MPH
Sommers MS, Dyehouse JM, Howe SR, et al.Effectiveness of brief interventions after alcohol-related vehicular injury: a randomized controlled trial. J Trauma. 2006;61(3):523–533.