Evaluating the effects of a brief motivational intervention for injured drinkers in the emergency department.

Cost-Effectiveness of a Motivational lntervention for Alcohol-Involved Youth in a Hospital Emergency Department

“…However, the trial demonstrated robust results across multiple dimensions of alcohol-involved behavior and included objective data from a Department of Motor Vehicles database of vehicular citations. Other studies of interventions in the ED have found similar outcomes with younger and older samples (Gentilello et al, 1999;Helmkamp et al, 2003;Longabaugh et al, 2001;Monti et al, in press;Spirito et al, 2004). To address the question of uncertainty in our estimate of treatment effect, we conducted both one-way and probabilistic sensitivity analyses that incorporated the 95% confidence interval of the impact on drinking and driving.…”

“…Monti et al (1999Monti et al ( , 2007 and Spirito et al (2004) have established that brief interventions conducted with adolescents in an emergency department (ED) reduce subsequent injuries and driving after drinking. Studies with older populations have also shown that ED interventions for problem alcohol use are efficacious in reducing alcohol-related consequences (Gentilello et al, 1999;Helmkamp et al, 2003;Longabaugh et al, 2001). In fact, the American College of Surgeons has mandated as a criterion for accreditation that trauma centers (i.e., EDs) have screening programs for problem drinkers, and that Level 1 centers (the highest level of ED accreditation) provide interventions for problem drinkers (American College of Surgeons, 2006).…”

Cost-effectiveness of screening and referral to an alcohol health worker in alcohol misusing patients attending an accident and emergency department: A decision-making approach

“…Attempts to conduct a randomised trial of brief intervention in an AED have proved difficult (Peters et al, 1998), although evidence is accumulating that brief intervention for alcohol misuse in AEDs may have clinical benefit (Longabaugh et al, 2001;Monti et al, 1999;Wright et al, 1998). In a recent study, opportunistic identification and referral to an alcohol health worker (AHW) in an AED was demonstrated to be feasible and associated with lower levels of alcohol consumption over the following year (Crawford et al, 2004).…”

The half-life of the ‘teachable moment’ for alcohol misusing patients in the emergency department

“…Excessive alcohol consumption has well documented adverse effects on health, and is commonly associated with presentation to Emergency Departments (EDs) Initial detection of alcohol misuse followed by Brief Intervention (BI) in the ED has been shown to be effective in reducing alcohol intake and lowering levels of ED reattendance (D'Onofrio et al, 1998a,b;Gentilello et al, 1999;Monti et al, 1999Longabaugh et al, 2001; however the initial detection and subsequent BI was carried out by research workers, as opposed to by ED staff themselves. Practical problems in carrying out opportunistic screening in EDs (Peters et al, 1998) can be mitigated by audit, education and feed-back (Huntley et al, 2001), and by the use of a robust pragmatic focused screening tool, e.g.…”