Search   |  Advanced

Research Summary

Brief Intervention for Patients Admitted to Emergency Services for Acute Alcohol Intoxication (AAI)

Emergency department (ED) visits for acute alcohol intoxication (AAI) are common. Using a pre-post study design, the authors compared 1-year AAI readmission rates among patients who received intensive care management* (ICM) in the ED and those who received standard care.** The intervention component of ICM lasted 10–15 minutes and was carried out twice within a 30-minute interval, with the second intervention including referral to treatment. Subjects were enrolled 24 hours a day over a 1-month period. Eighty percent were identified as needing emergency treatment by ambulance personnel or police. There were no differences between ICM and standard care control groups in baseline GGT and CDT levels.

  • In the ICM group (n=106), 71% of subjects received the brief intervention, and 59% were referred to outpatient treatment or specialized hospitalization.
  • In the control group (n=97), 43% of subjects were referred to outpatient treatment or specialized hospitalization.
  • The AAI readmission rate was lower in the ICM group than in the control group (32% versus 59%).
  • Assignment to outpatient treatment or hospitalization was associated with less readmission for AAI in the ICM group but not in the control group.

*Delivery of staff training and setup of ICM care protocols in the ED + a behavioral intervention based on FRAMES (Feedback, Responsibility, Advice, Menu, Empathy, Self-efficacy) provided by a specialized addiction-medicine liaison.
**Medical care for AAI or withdrawal only.

Comments:

This naturalistic study offers evidence that a liaison team specially trained to implement alcohol brief intervention and treatment within the ED may decrease readmission among patients presenting with acute intoxication. Randomized trials are needed to confirm efficacy. Intoxicated patients remained hospitalized until the next morning in this study, since interventions were conducted between 8 a.m. and 11 a.m. This may seem an encumbrance for ED staff but has the potential to positively impact readmissions—an even more significant burden for the ED. Nicolas Bertholet, MD, MSc

Reference:

Schwan R, Di Patritio P, Albuisson E, et al. Usefulness of brief intervention for patients admitted to emergency services for acute alcohol intoxication. Eur J Emerg Med. 2012;19(6):384–388.

logos