Brief Motivational Interventions Targeting Alcohol Use for Young Emergency Department Patients: State of the Evidence

This systematic review and meta-analysis investigated the state of evidence for brief motivational interventions (BMI) for young emergency department patients with past or present risky alcohol use (according to self-report, blood, breath, and/or high-risk behavior with alcohol use). Studies were included if they used a randomized controlled trial design, evaluated BMI that targeted alcohol use in an emergency care setting, and included at least some people aged 18 or younger. Studies were excluded if they included participants older than 25, did not report drinking outcomes, or were not published in English or German peer-reviewed sources.

• Authors identified 8 articles reporting on 6 different trials, for a total of 1433 participants aged 13–25, with a follow-up range of 3–12 months. Intervention duration was between 5 and 45 minutes (median length = 37 minutes). Control conditions were: written information, contact list, phone follow-up, or personal feedback.
• Two trials found evidence that BMI was efficacious in reducing alcohol use. Four trials showed effects of BMI on alcohol-related problems or consequences. BMI was never less efficacious than the control condition.
• In the meta-analysis, with a best case scenario approach (i.e., identifying in each study the follow-up point with the largest mean difference between BMI and control), drinking frequency was significantly lower in BMI groups (standardized mean difference, -0.17). There was no advantage over control conditions on quantity of drinking. In a conservative scenario, no differences were observed between BMI and control.

Comments:

This systematic review indicates possible benefits of BMI in emergency care to reduce alcohol use among young people. Further research is needed to better understand what makes some interventions effective at all, and more effective than others, and to identify the potential benefits of BMI over less complex interventions.

Nicolas Bertholet, MD, MSc

Reference:

Kohler S, Hofmann A. Can motivational interviewing in emergency care reduce alcohol consumption in young people? A systematic review and meta-analysis. Alcohol Alcohol. 2015;50(2):107–117.