Motivational interviewing versus feedback only in emergency care for young adult problem drinking

Abstract

Aim To establish the efficacy of a brief motivational intervention compared to feedback only when delivered in an emergency department for reducing alcohol use and problems among young adults. Design Two-group randomized controlled trial with follow-up assessments at 6 and 12 months. Setting Level I Trauma Center. Participants A total of 198 18-24-year-old patients who were either alcohol positive upon hospital admission or met screening criteria for alcohol problems. Intervention Participants were assigned randomly to receive a one-session motivational intervention (MI) that included personalized feedback, or the personalized feedback report only (FO). All participants received additional telephone contact 1 month and 3 months after baseline. Measurements Demographic information, alcohol use, alcohol problems and treatment seeking. Findings Six months after the intervention MI participants drank on fewer days, had fewer heavy drinking days and drank fewer drinks per week in the past month than did FO patients. These effects were maintained at 12 months. Clinical significance evaluation indicated that twice as many MI participants as FO participants reliably reduced their volume of alcohol consumption from baseline to 12 months. Reductions in alcohol-related injuries and moving violations, and increases in alcohol treatment-seeking were observed across both conditions at both follow-ups with no differences between conditions. Conclusions This study provides new data supporting the potential of the motivational intervention tested to reduce alcohol consumption among high-risk youth.

Reviewing and interpreting the effects of brief alcohol interventions: comment on a Cochrane review about motivational interviewing for young adults

“…The above‐mentioned concerns with risk of bias assessments relying on reported data only are compounded by the lack of specifically searching grey literature sources, where further information about ‘unclear’ risks of bias could potentially be found. Moreover, at least two reports thought by review authors to be from different studies appear to be the same study (Barnett et al ., 2010 32 and Monti et al ., 2007 33). Limitations in the search strategy's ability to identify and properly classify the primary literature in this area should further temper definitive conclusions.…”

Substance Use Screening, Brief Intervention, and Referral to Treatment for Pediatricians

“…Adolescents who have had relatively minor consequences associated with their substance use should be engaged in a brief negotiated interview (BNI) based on motivational principles to encourage abstinence or risk reduction (Fig 1, lower- Brief negotiated interviews have been used successfully to reduce both alcohol [28][29][30] and marijuana 31 use by adoles-cents in emergency care settings. These studies all used multicomponent interventions delivered by peer health educators.…”

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

“…One evidence-based approach is to intervene with youth receiving emergency medical treatment for an alcohol-related injury. 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).…”