Telephone Booster Increases Efficacy of Brief Alcohol Intervention for Injured Patients

To determine the most effective way to deliver brief intervention to trauma patients with unhealthy alcohol use, this 3-site clinical trial randomized 596 injured patients to brief advice (n = 200), brief motivational intervention (BMI; n = 203), or BMI plus a telephone booster (BMI+B; n = 193). The telephone booster lasted an average of 28 minutes and was delivered 30 days after the BMI, providing personalized feedback based on the initial interview. Follow-up rates were 80% at 3 months, 79% at 6 months, and 75% at 12 months.

• Compared with brief advice and BMI, the BMI+B group reduced…
  • weekly consumption by 1.2 standard drinks at 3 months and 1.4 at 6 months;
  • the number of drinks per drinking day by 1.5 drinks at 3 months and 1.3 at 6 months;
  • the percentage of heavy drinking days (defined as 4 drinks on an occasion for men or 3 for women) at 6 months by 6%;
  • the maximum number of drinks in a day by 1.4 drinks at 3 months and 1.7 at 12 months.
• The intervention had no effect on alcohol-related problems.

Comments:

BMI with a telephone booster 30 days later was more efficacious than BMI or brief advice alone in reducing unhealthy drinking among trauma patients. The effects differentiating BMI from brief advice were slight and suggest that a booster intervention might work even after a minimal intervention at the time of the injury. In settings where post-trauma telephone calls are not routine, clinicians seeing patients in follow-up after an injury are ideally positioned to deliver such a booster.

Peter D. Friedmann, MD, MPH

Reference:

Field C, Walters S, Marti CN, et al. A multisite randomized controlled trial of brief intervention to reduce drinking in the trauma care setting: how brief is brief? Ann Surg. 2014;259(5);873–879.