A Systematic Review on the Effectiveness of Brief Interventions for Alcohol Misuse among Adults in Emergency Departments

Landy, Meredith S. H.; Davey, Caitlin J.; Quintero, David; Pecora, Amanda; McShane, Kelly

doi:10.1016/j.jsat.2015.08.004

Cited by 50 publications

(50 citation statements)

References 45 publications

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“…First, commensurate with the findings from our prior drug use ED BI study and from multiple other ED alcohol or drug use intervention studies (Bazargan-Hejazi et al, 2005; Bogenschutz et al, 2014; D'Onofrio et al, 2012; D'Onofrio et al, 2008; Landy et al, 2016; Merchant et al, 2015; Woodruff et al, 2014), we observed reductions in self-reported alcohol use among all study participants (both BI and no BI arms). A hopeful explanation for this observation is that asking adult ED patients to self-report their alcohol use via a confidential questionnaire and giving minimal feedback that they need an intervention motivated these patients to reduce their alcohol use, regardless of whether not receiving a BI.…”

Section: Discussionsupporting

confidence: 83%

“…This short-term but no long-term additional decline also has been observed in prior ED alcohol intervention studies. (Academic ED SBIRT Research Collaborative, 2010; D'Onofrio et al, 2008; Landy et al, 2016) Possible explanations for this observation are that an intervention performed in the ED (alcohol self-assessment questionnaires with or without an intervention) has little additional impact after the short-term or the intervention is limited in how much it can reduce alcohol use (i.e., a maximum effect of the intervention). If these explanations are true, booster or ongoing interventions over time or a self-assessment questionnaire intervention combined with additional interventions might be better approaches for the long-term.…”

Section: Discussionmentioning

confidence: 99%

“…(Babor et al, 2007) ED-based BIs for alcohol use have shown efficacy in some studies, (Academic, 2010; Bazargan-Hejazi et al, 2005; Bernstein et al, 2010; D'Onofrio et al, 2012; Longabaugh et al, 2001; Mello et al, 2013) but not in others. (Landy, Davey, Quintero, Pecora, & McShane, 2016; Nilsen et al, 2008) ED-based (Bogenschutz et al, 2014; Woodruff et al, 2014) and outpatient BIs (Roy-Byrne et al, 2014; Saitz et al, 2014) for drug use have not been efficacious, at least not as previously attempted. In a previous randomized, controlled trial evaluating a BI for adult ED patients in need of an intervention for their drug use (per World Health Organization (WHO) criteria), (Humeniuk, 2010) we also found that participants who received an alcohol and drug use BI did not decrease their drug use more than those in an assessment only condition (completed questionnaires but did not receive a BI).…”

Section: Introductionmentioning

confidence: 95%

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Impact of a brief intervention on reducing alcohol use and increasing alcohol treatment services utilization among alcohol- and drug-using adult emergency department patients

Merchant

Romanoff

Zhang

et al. 2017

Alcohol

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Most previous brief intervention (BI) studies have focused on alcohol or drug use, instead of both substances. Our primary aim was to determine if an alcohol and drug use BI reduced alcohol use and increased alcohol treatment services utilization among adult emergency department (ED) patients. Our secondary aims were to assess when the greatest relative reductions in alcohol use occurred, and which patients (stratified by need for an alcohol use intervention) reduced their alcohol use the most. We studied a sub-sample of participants from a randomized, controlled trial of a BI vs. no BI whose responses to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) indicated a need for a BI for any drug use and who also reported alcohol use. Participants were stratified by their ASSIST alcohol subscore: (1) no BI needed, (2) a BI needed, or (3) an intensive intervention needed for alcohol use. Alcohol use and alcohol treatment services utilization were measured every three months for 12 months post-enrollment. Of these 833 participants, median age was 29 years-old, 46% were female; 55% were white/non-Hispanic, 27% black/non-Hispanic and 15% Hispanic. Although any alcohol use, alcohol use frequency, days of alcohol use, typical drinks consumed/day, and most drinks consumed/day decreased in both the BI and no BI arms, there were no differences between study arms. Few patients sought alcohol use treatment services in follow-up, and utilization also did not differ by study arm. Compared to baseline, alcohol use reduced the most during the first three months after enrollment, yet reduced little afterwards. Participants whose ASSIST alcohol subscores indicated a need for an intensive intervention generally had the greatest relative decreases in alcohol use. These results indicate that the BI used was not efficacious in reducing alcohol use among alcohol- and drug-using adult ED patients. There is a need to develop and test more robust interventions.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

See 1 more Smart Citation

Impact of a brief intervention on reducing alcohol use and increasing alcohol treatment services utilization among alcohol- and drug-using adult emergency department patients

Merchant

Romanoff

Zhang

et al. 2017

Alcohol

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“…The two most common behavioral therapies used in SBIRT programs are brief versions of cognitive behavioral therapy and motivational interviewing, or some combination of the two. There is substantial research on the effectiveness of SBIRT in reducing risky alcohol consumption (Bertholet et al 2005; Cochran et al 2015; Kaner et al 2009; Landy et al 2015; Ouimet et al 2013; Patton et al 2014; Steinka-Fry et al 2015; Teeters et al 2015; Whitlock et al 2004; Wojnar and Jakubczyk 2014). …”

Section: Five Important But Not Highest Priority Strategiesmentioning

confidence: 99%

Can progress in reducing alcohol-impaired driving fatalities be resumed? Results of a workshop sponsored by the Transportation Research Board, Alcohol, Other Drugs, and Transportation Committee (ANB50)

Fell

Beirness

Voas

et al. 2016

Traffic Injury Prevention

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Objective Despite successes in the 1980s and early 1990s, progress in reducing impaired driving fatalities in the United States has stagnated in recent years. Since 1997, the percentage of drivers involved in fatal crashes with illegal blood alcohol concentration (BAC) levels has remained at approximately 20% to 22%. Many experts believe that public complacency, competing social and public health issues, and the lack of political fortitude have all contributed to this stagnation. The number of alcohol-related crashes, injuries, and fatalities is still unacceptable, and most are preventable. The public needs to be aware that the problem presented by drinking drivers has not been solved. Political leaders need guidance on which measures will affect the problem, and stakeholders need to be motivated once again to implement effective strategies. Methods The National Academy of Sciences (NAS) Transportation Research Board (TRB) Alcohol, Other Drugs, and Transportation Committee (ANB50) sponsored a workshop held at the NAS facility in Woods Hole, MA, on August 24–25, 2015, to discuss the lack of progress in reducing impaired driving and to make recommendations for future progress. A total of 26 experts in research and policy related to alcohol-impaired driving participated in the workshop. The workshop began by examining the static situation in the rate of alcohol-impaired driving fatal crashes to determine what factors may be inhibiting further progress. The workshop then discussed eight effective strategies that have not been fully implemented in the United States. Workshop participants (16 of the 26) rated their top three strategies. Results Three strategies received the most support: Impose administrative sanctions for drivers with BACs = .05 to .08 g/dL.Require alcohol ignition interlocks for all alcohol-impaired driving offenders.Increase the frequency of sobriety checkpoints, including enacting legislation to allow them in the 11 states that currently prohibit them. Five other important strategies included the following: (a) increase alcohol taxes to raise the price and reduce alcohol consumption; (b) re-engage the public and raise the priority of impaired driving; (c) lower the illegal per se BAC limit to .05 for a criminal offense; (d) develop and implement in-vehicle alcohol detection systems; and (e) expand the use of screening and brief interventions in medical facilities. Conclusions Each of these strategies is proven to be effective, yet all are substantially underutilized. Each is used in some jurisdictions in the United States or Canada, but none is used extensively. Any one of the three strategies implemented on a widespread basis would decrease impaired driving crashes, injuries, and fatalities. Based on the research, all three together would have a substantial impact on the problem.

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“…SBI has a growing evidence base for its effectiveness [12,13,14,15], however there is an absence of evidence for those experiencing more severe alcohol use problems [12,14,16]. Reviews of previous studies of electronic screening and brief interventions (eSBI) have also found inconsistent evidence as to their effectiveness with high-risk drinkers, with an acknowledgement that, while webbased interventions appear to be well received, further controlled trials examining engagement and efficacy are needed within this population [17].…”

Section: Introductionmentioning

confidence: 99%

Alcohol Consumption Reduction Among a Web-Based Supportive Community Using the Hello Sunday Morning Blog Platform: Observational Study (Preprint)

Kirkman¹,

Leo²,

Moore³

2017

Preprint

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A Systematic Review on the Effectiveness of Brief Interventions for Alcohol Misuse among Adults in Emergency Departments

Cited by 50 publications

References 45 publications

Impact of a brief intervention on reducing alcohol use and increasing alcohol treatment services utilization among alcohol- and drug-using adult emergency department patients

Impact of a brief intervention on reducing alcohol use and increasing alcohol treatment services utilization among alcohol- and drug-using adult emergency department patients

Can progress in reducing alcohol-impaired driving fatalities be resumed? Results of a workshop sponsored by the Transportation Research Board, Alcohol, Other Drugs, and Transportation Committee (ANB50)

Alcohol Consumption Reduction Among a Web-Based Supportive Community Using the Hello Sunday Morning Blog Platform: Observational Study (Preprint)

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