Brief Interventions for Hazardous and Harmful Alcohol Consumption in Accident and Emergency Departments

Abstract

The prevalence of alcohol abuse among patients treated in accident and emergency departments (A&E) is considered as substantial. This paper is a narrative review of studies investigating the effectiveness of brief interventions (BI) for hazardous and harmful alcohol consumption in A&E. A&E departments in hospitals (and other health care infrastructures) are commonly the place where serious consequences of alcohol drinking are seen and need to be tackled, supporting the suggested theoretical usefulness of delivering BI in this environment. Available research shows that BI may be considered a valuable technique for dealing with alcohol-related problems. However, it is suggested that the usefulness of BI may depend significantly on the target population to be dealt with. BI have proved to be beneficial for male individuals and those patients who do not abuse other psychoactive substances. In contrast, evidence indicates that BI in A&E settings are not effective at all when dealing with men admitted as a consequence of a violence-related event. In addition, some studies were unable to confirm the effectiveness of BI in female population, in emergency setting. Studies investigating the association between drinking patterns and the effectiveness of BI also present inconsistent results. Most studies assessing the effectiveness of BI in A&E settings only adopted a short perspective (looking at the impact up to a maximum of 12 months after the BI was delivered). When assessing the effects of BI, both the amount of alcohol consumed and expected reductions in alcohol consequences, such as injuries, can be taken into account. Evidence on the implementation of brief intervention in emergency departments remains inconclusive as to whether there are clear benefits. A variety of outcome measures and assessing procedures were used in the different studies, which have investigated this topic.

A randomized clinical trial of mobile phone motivational interviewing for alcohol use problems in Kenya

“…This marked reduction in alcohol use among our mobile MI group is sustained at 6 months, suggesting that motivation to change behavior continues after the immediate post‐intervention phase. Our findings contribute to the existing evidence that brief interventions help to reduce alcohol use in high‐ and low‐income countries , including studies in Kenya at the intersection of alcohol abuse and HIV/AIDS , and in some cases result in alcohol cessation .…”

“…Evidence‐based brief intervention models for AUDs have been tested in primary care settings in high‐income countries but less so in low‐ and middle‐income countries . Motivational interviewing (MI) is a type of brief intervention that uses open‐ended questions, affirmations, reflective listening and summarizing as key tools .…”

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)

“…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). …”

Evaluation of a brief intervention to reduce the negative consequences of drug misuse among adult emergency department patients

“…Although their use has been recommended (Cunningham et al, 2009), brief interventions (BIs) have had mixed results in reducing or eliminating alcohol consumption among adolescent and ED patients (Nilsen et al, 2007; Havard et al, 2008; Yuma-Guerrero et al, 2012; Cochran et al, 2014; Dent et al, 2008; Wojnar and Jakubczyk, 2014; , 2008; Sommers et al, 2013; Bernstein et al, 2010; Academic ED SBIRT Research Collaborative, 2010; Newton et al, 2013). Furthermore, researchers have identified either decreases (Longabaugh et al, 2001; Blow et al, 2006) or no impact (Mello et al, 2013; D’Onofrio et al, 2012) of BIs on ED adult patient reported negative consequences of alcohol consumption as compared to control conditions.…”