Effectiveness of a specialized brief intervention for at-risk drinkers in an Emergency Department. Short term results of a randomized controlled trial

Abstract

Background and aims

SBIRT programmes (Screening Brief Intervention and Referral to Treatment) have been developed, evaluated and shown to be effective, particularly in primary care and general practice. Nevertheless, effectiveness of SBIRT in emergency departments (ED) has not been clearly established.

We aimed to evaluate the feasibility and efficacy of an SBIRT programme conducted by highly specialized professionals in the ED of a tertiary hospital.

Methods

We conducted a randomized controlled trial to study the feasibility and efficacy of an SBIRT programme conducted by alcohol specialists for at-risk drinkers presenting to the ED, measured with the AUDIT-C. Patients were randomized to two groups, with the control group receiving two leaflets - one regarding alcohol use, and the other giving information about the study protocol. The intervention group received the same leaflets as well as a brief motivational intervention on alcohol use; and, where appropriate, a referral to specialised treatment. The primary outcomes were the proportion of at-risk alcohol use measured by AUDIT-C scale and the proportion of patients attending specialised treatment at 1.5 months.

Results

Of 3027 patients presenting to the ED, 2044 (67%) were potentially eligible to participate, 247 (12%) screened positive for at-risk drinking and 200 agreed to participate. 72% of the participating sample were men, and the mean age was 43 years. Follow-up rates were 76.5%. At 1.5 months, the intervention group showed greater reductions in alcohol consumption, and fewer patients continuing with at-risk alcohol use (27.8% vs 48.1%. P=0.01). The SBIRT programme also increased the probability of atending specialised treatment, compared to the control condition (23% vs 9.8%, p=0.0119)

Conclusion

The SBIRT programme in the ED was found to be feasible and effective in identifying at-risk drinkers, reducing at-risk alcohol use and increasing treatment for alcohol problems.

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