Brief Interventions Efficacious for Unhealthy Alcohol Use in Hospital Inpatients

Evidence for the efficacy of hospital-based alcohol brief intervention is mixed. In a randomized trial, researchers tested a 30-minute brief motivational intervention repeated 2–3 times among Taiwanese male medical and surgical inpatients identified by screening as having unhealthy alcohol use.* Almost half of the 616 participants met DSM-IV criteria for dependence. Patients receiving specialty alcohol treatment at baseline were excluded. The intervention was done by social workers who completed a 5-day training course and were supervised weekly with use of recorded sessions.

• More intervention- than control-group participants (80% versus 70%) completed follow-up.

• At 12 months, compared with the control group, the intervention group reported fewer heavy drinking days (2 versus 3), fewer drinks (32 versus 49), and fewer drinking days (3 versus 4) in the past week. Findings were similar among those with dependence.

• Although use of specialty treatment was greater in the intervention group (8% versus 2%), there were no significant differences in alcohol-related problems or health-care utilization  between groups.

Comments:

This study is important because it was large and found benefit, although the authors suggest their results could be due to social desirability bias (i.e., report of less drinking in the intervention group that was more likely to follow up), particularly with self-reported consumption. Selection of a population with less severe unhealthy use (and less comorbid drug use, the prevalence of which was not reported) may also account for efficacy not seen other trials. Nevertheless, it appears some hospitalized patients may respond to brief intervention. Whether the selection of patients who will respond and the frequency and quality of the brief intervention can be reproduced in other hospitals remains to be seen.

Richard Saitz MD, MPH

Reference:

Liu SI, Wu SI, Chen SC, et al. Randomized controlled trial of a brief intervention for unhealthy alcohol use in hospitalized Taiwanese men. Addiction. 2011;106(5):928–940.