Can Brief Alcohol Intervention That Includes Referral Lead to Receipt of Treatment by Medical and Surgical Inpatients?

There is evidence that receiving specialized alcohol treatment is beneficial to people with alcohol use disorder (AUD); medical and surgical wards may present an opportunity to refer people to treatment. This systematic review of randomized controlled trials (RCTs) aimed to identify interventions for increasing subsequent alcohol treatment utilization among patients with AUD in these settings. Studies conducted among people <18 years were excluded, as were those focusing on pharmacological treatments.

• Authors identified 5 RCTs meeting the inclusion criteria.
• Two studied a single-session brief intervention (BI); 1 a multi-session BI; and 2 a BI with post-discharge sessions.
• Of the 5 trials, 2 reported that the intervention was associated with alcohol treatment utilization at 12 months (odds ratio [OR], 4.2 and 3.9). These trials reported on BI with post-discharge sessions. The other 3 trials showed no effect of the intervention on subsequent alcohol treatment utilization.

Comments:

One of the key findings of this study is the limited availability of data on referral to alcohol treatment among patients in medical and surgical wards. As of today, no conclusion can be drawn as to which intervention might work in increasing treatment receipt, but all identified studies that looked at BIs only conducted while patients were hospitalized failed to demonstrate an increase. But interventions with post-discharge sessions may be beneficial. Future studies should also note whether patients referred are identified by screening and unaware of their treatment need or if they are seeking help as brief interventions will likely have differing success depending on such factors.

Nicolas Bertholet, MD, MSc

Reference:

Simioni N, Cottencin O, Rolland B. Interventions for increasing subsequent alcohol treatment utilisation among patients with alcohol use disorders from somatic inpatient settings: a systematic review. Alcohol Alcohol. 2015;50(4):420–429.