Randomized controlled trial of a brief intervention for unhealthy alcohol use in hospitalized Taiwanese men

Abstract

Data from Taiwan confirm that brief in-hospital intervention can result in a reduction in alcohol intake by men who drink heavily or are diagnosed with an alcohol use disorder.

Is there really no evidence of the efficacy of brief alcohol interventions for increasing subsequent utilization of alcohol‐related services? Commentary on the paper by Glass et al. (2015)

“…The RCT by Apodaca et al [2] reported an increase in further treatment-seeking at 5 months among a sample of inpatients from a trauma centre with a mean Alcohol Use Disorders Identification Test (AUDIT) score of 20 for brief advice, compared with the control group [6 of 15 (40%) versus two of 15 (13%)], but this increase was not found statistically significant given the small sample size (n = 40). The study by Liu et al [3] (n = 616) also reported that brief intervention with post-discharge sessions was associated significantly with treatment utilization at 12 months in in-patients from medical/surgical wards [8.3 versus 2.1%, P = 0.01 (OR) = 4.2, 95%, CI = 1.4-12.4)].…”

“…However, the search and screening processes of their systematic review did not apparently identify three RCTs on referral-specific interventions. Two of these three RCTs are indexed in MEDLINE and/or in PsycINFO (Apodaca et al, 2007 [2]; Liu et al, 2011 [3]), and one is an unpublished report (Runge et al, 2002 [4]). All three RCTs exhibited favourable findings for the effectiveness of brief interventions in increasing subsequent alcohol treatment utilization.…”

“…They published two systematic reviews this year in other peer-reviewed addiction journals on this topic [3,4]. The major differences between our review and theirs is that our study metaanalyzed the data, whereas they were focused on providing an overview of the literature, and each research team chose different eligibility criteria leading to slightly different samples of trials.…”

“…The major differences between our review and theirs is that our study metaanalyzed the data, whereas they were focused on providing an overview of the literature, and each research team chose different eligibility criteria leading to slightly different samples of trials. Through a meta-analysis of randomized controlled trials (RCTs), we determined that there was a lack of evidence to support the efficacy of brief interventions, as currently implemented, in increasing the utilization of alcohol treatment [1], whereas they determined, based on qualitative summaries of RCTs and non-RCTs, that there is no firm evidence or limited evidence [3,4].…”

The two forms of alcohol brief intervention: an uneasy coalition

“…This hypothesis has been tested with encouraging results [11][12][13], although not in primary care.…”