Examining the reach of a brief alcohol intervention service in routine practice at a level 1 trauma center

Abstract

The American College of Surgeons requires Level I and II trauma centers to provide brief intervention services to traumatically injured patients who screen positive for alcohol. Despite evidence supporting substantial cost savings and reduced re-injury associated with these services, brief interventions may not be uniformly delivered owing to a variety of demographic, clinical and operational characteristics. To inform service adjustments that may improve the reach of such services, we compared trauma patients who did and did not receive brief alcohol intervention services during their hospitalizations. Electronic medical records of injured patients admitted to a Level I trauma center between September 27, 2013 and March 11, 2014 with a positive blood alcohol concentration (N = 189) were coded for demographic and clinical variables. Records of those who did not receive a brief intervention during their admission were reviewed for possible reasons why interventions were not delivered. Of the total sample, 115 patients (60.8%) received brief interventions. Patients who did and did not receive brief interventions did not differ on age, sex, race, blood alcohol concentration at admission, or mechanism of injury, indicating that patient characteristics were unlikely to bias service delivery. Instead, common features of patients who were referred but did not receive SBIRT interventions included admissions lasting fewer than two working days (12.7%) and persistent cognitive impairment following injury (9.0%). These findings align with previous studies suggesting that service reach could be improved by promoting dedicated and flexible staffing and adapting services to allow for SBIRT delivery in follow-up care settings.

Willingness to Participate in Alcohol Prevention Interventions Targeting Risky Drinking Employees. The WIRUS Project

“…As such, one may assume that willing and unwilling employees were not systematically different with regard to how much they drank, how they construed drinking in general as well as work-related drinking more specifically, and what effects they expected alcohol to produce. These findings are in line with previous studies that have revealed no systematic differences in terms of intervention participation based on weekly consumption and frequency of heavy episodic drinking (35), overall alcohol use and consequences (36), typical number of drinks per week (38), or blood alcohol concentration (37). We did, however, find that those willing to participate reported less alcohol-related presenteeism, i.e., occurrences of episodes where on-the-job performance have been thwarted by alcohol consumption.…”

“…In line with the Swedish study, participants and non-participants in the German study did not differ on variables such as gender, employment status, and alcohol consumption. Similar results have been found among American trauma patients eligible for a brief face-to-face intervention administered by health care personnel (37). A study of a general population sample in Germany (visitors at a municipal registry office, i.e., a public authority for registration, passport and vehicle administration issues) (38) did, however, report that low-risk drinkers had higher odds of participating in a digital intervention with computer-generated feedback than risky drinkers.…”

“…In line with earlier studies on willingness to participate in alcohol prevention interventions (35)(36)(37)(38), a set of sociodemographic and alcohol-related variables was included as potential correlates.…”

Cues to care: Chronic disease diagnosis in young adult trauma patients

“…Prior studies have shown that shorter hospital lengths of stay, as seen in our study population, are a barrier to intervention and treatment of chronic disease. 8 However, despite median stays ranging from 2 to 4 days, outcomes were significantly different between cohorts. The cohorts that had patients with UD-UD and PD-UD cohorts-had higher rates of inpatient complications, intensive care unit admission, and 30-day ED visits.…”

“…For trauma patients diagnosed with substance and alcohol use, some programs have shown outpatient success when screening and interventions are initiated during inpatient trauma admission. 8 Although early screening measures can be cost-effective and do not require additional patient testing or procedures, best-practice models are lacking for young adult inpatients. 9 We hypothesized that there would be a high prevalence of chronic disease, both diagnosed and undiagnosed, in the young adult trauma population.…”