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Research Summary

Effectiveness of Alcohol Screening and Brief Intervention in a Polish Emergency Department

The effectiveness of screening and brief intervention (SBI) for alcohol in the emergency department (ED) is uncertain. Prior negative findings may be due, in part, to lower levels of at-risk drinking among participants or assessment reactivity among controls. In this study, researchers randomized 446 ED patients with at-risk* or dependent** drinking to 1 of 3 groups: screen-only (n=147, 83% men), assessment (n=152, 86% men), or intervention (n=147, 85% men). The intervention group received a 15–20 minute brief motivational intervention by a nurse. The assessment and intervention groups received follow-up assessments at 3 and 12 months; the screen-only group received follow-up assessment at 12 months only.

  • Twelve-month follow-up rates were 63%, 65%, and 59% in the screen-only, assessment, and intervention groups, respectively.
  • At-risk drinking decreased from baseline to 12 months in each group (screen-only, 87% to 54%; assessment, 89% to 65%; intervention, 88% to 64%) as did dependent drinking (screen only, 25% to 21%; assessment, 35% to 24%; intervention, 43% to 24%).
  • All 3 groups had significant reductions in drinks per drinking day at 12 months.
  • No significant difference in drinking outcomes was found among the 3 groups at 12 months.

*Defined as ≥11 US standard (12–14 g) drinks per week or ≥4 or more per drinking day for men and ≥6 drinks per week or ≥3 per drinking day for women.

**Defined as ≥1 positive responses on the 4-item Rapid Alcohol Problems Screen.

Comments:

All 3 groups improved at 12 months, suggesting that neither intervention nor assessment were responsible for the improved outcomes. A single brief intervention may be insufficient for heavier drinking populations, particularly those with dependence. Whether booster sessions or other approaches will make brief interventions effective for such patients remains to be seen. Kevin L. Kraemer, MD, MSc

Reference:

Cherpitel CJ, Korcha RA, Moskalewicz J, et al. Screening, brief intervention, and referral to treatment (SBIRT): 12-month outcomes of a randomized controlled clinical trial in a Polish emergency department. Alcohol Clin Exp Res. 2010; 34(11):1–7.

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