Sick days in general hospital patients two years after brief alcohol intervention: Secondary outcomes from a randomized controlled trial

Freyer‐Adam, Jennis; Baumann, Sophie; Bischof, Gallus; John, Ulrich; Gaertner, Beate

doi:10.1016/j.ypmed.2020.106106

Cited by 10 publications

(13 citation statements)

References 47 publications

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“…In contrast to low-risk drinkers, there was no significant BAI effect among at-risk drinkers. This contradicts findings on a previous version of the same BAI used in this study, which was efficacious over 24 months among at-risk drinking general hospital inpatients [35][36][37][38][39]. Five explanations may be considered.…”

Section: Discussioncontrasting

confidence: 99%

Effects of a brief alcohol intervention addressing the full spectrum of drinking in an adult general population sample: a randomized controlled trial

et al. 2021

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Background and aims Evidence for efficacy of brief alcohol interventions (BAIs) is mainly limited to primary care and at‐risk drinkers. The aim was to test the efficacy of a BAI addressing the full spectrum of alcohol use in a general population sample and across alcohol risk groups. Design Two‐parallel‐group randomized controlled trial (allocation ratio 1:1) with post‐baseline assessments at months 3, 6 and 12. Setting One municipal registry office in Germany responsible for registration, passport and vehicle admission issues. Participants A total of 1646 proactively recruited 18–64‐year‐old adults with past year alcohol use (56% women, 66% low‐risk drinkers) were randomized to intervention (n = 815) or control (n = 831). Intervention and comparator The intervention consisted of assessment plus computer‐generated individualized feedback letters at baseline and months 3 and 6. Comparator was assessment only. Measurements Primary outcome was change in the self‐reported number of drinks/week from baseline to 12 months. Changes at 3 and 6 months were secondary outcomes. Moderator was alcohol risk group (low‐risk versus at‐risk drinking) according to the Alcohol Use Disorders Identification Test–Consumption, with scores from 1‐3 (women) and from 1‐4 (men) indicating low‐risk drinking. Findings For the whole sample, significant group differences were observed neither at 12‐month follow‐up [incidence rate ratio (IRR) = 1.01, 95% confidence interval (CI) = 0.87–1.17, Bayes factor (BE) = 0.52] nor at previous assessments (month 3: IRR = 1.01, 95% CI = 0.92–1.12, BE = 0.41; month 6: IRR = 0.93, 95% CI = 0.81–1.07, BE = 1.10). Moderator analyses revealed that low‐risk drinkers were more likely to benefit from BAI only at month 6 than at‐risk drinkers (IRR = 0.77, 95% CI = 0.70–0.86). Conclusions In a randomized controlled trial, there was no clear evidence for efficacy of a computer‐based brief alcohol intervention in a general population sample, but there was some evidence of medium‐term benefits in the large but understudied group of low‐risk drinkers.

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Section: Discussioncontrasting

confidence: 99%

Effects of a brief alcohol intervention addressing the full spectrum of drinking in an adult general population sample: a randomized controlled trial

et al. 2021

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“…These interventions have been shown to successfully reduce the respective HRBs and to improve measures of health in healthcare patients over 2 years. 28–31 These two interventions were slightly modified and integrated into the PAL intervention as two separate modules. PAL consists of five modules, that is, one HRB profile module and one module for each of the four HRBs:…”

Section: Methods and Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…27 With regards to decreasing alcohol use, tobacco smoking and improving measures of health, TTM-based interventions targeting single behaviours have been found to produce desirable changes over 2 years in healthcare patients. [28][29][30][31] General hospitals may provide an ideal setting to approach patients for the delivery of comprehensive lifestyle interventions for several reasons: First, two-thirds of general hospital patients report multiple of the four HRBs. 12 Second, with participation rates of 80% and higher, general hospital patients have been found to be reached well for individual interventions targeting single behaviours.…”

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Proactive automatised lifestyle intervention (PAL) in general hospital patients: study protocol of a single-group trial

et al. 2022

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IntroductionThe co-occurrence of health risk behaviours (HRBs, ie, tobacco smoking, at-risk alcohol use, insufficient physical activity and unhealthy diet) increases the risks of cancer, other chronic diseases and mortality more than additively; and applies to more than half of adult general populations. However, preventive measures that target all four HRBs and that reach the majority of the target populations, particularly those persons most in need and hard to reach are scarce. Electronic interventions may help to efficiently address multiple HRBs in healthcare patients. The aim is to investigate the acceptance of a proactive and brief electronic multiple behaviour change intervention among general hospital patients with regard to reach, retention, equity in reach and retention, satisfaction and changes in behaviour change motivation, HRBs and health.Methods and analysisA pre–post intervention study with four time points is conducted at a general hospital in Germany. All patients, aged 18–64 years, admitted to participating wards of five medical departments (internal medicine A and B, general surgery, trauma surgery, ear, nose and throat medicine) are systematically approached and invited to participate. Based on behaviour change theory and individual HRB profile, 175 participants receive individualised and motivation-enhancing computer-generated feedback at months 0, 1 and 3. Intervention reach and retention are determined by the proportion of participants among eligible patients and of participants who continue participation, respectively. Equity in reach and retention are measured with regard to school education and other sociodemographics. To investigate satisfaction with the intervention and subsequent changes, a 6-month follow-up is conducted. Descriptive statistics, multivariate regressions and latent growth modelling are applied.Ethics and disseminationThe local ethics commission and data safety appointee approved the study procedures. Results will be disseminated via publication in international scientific journals and presentations on scientific conferences.Trial registration numberNCT05365269.

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“…As they require fewer resources than in-person delivered interventions, their potential impact on public health and social equity may be considered high. Among general hospital patients, our research group showed that computer-based BAI was no less effective than in-person BAI in reducing alcohol use and improving measures of health over two years [ 29 - 31 ]. Thus, computer-based BAI appears to be incorporable into a broader health care program.…”

Section: Introductionmentioning

confidence: 99%

Social Equity in the Efficacy of Computer-Based and In-Person Brief Alcohol Interventions Among General Hospital Patients With At-Risk Alcohol Use: A Randomized Controlled Trial

Freyer‐Adam¹,

Baumann²,

Bischof³

et al. 2022

JMIR Ment Health

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Background Social equity in the efficacy of behavior change intervention is much needed. While the efficacy of brief alcohol interventions (BAIs), including digital interventions, is well established, particularly in health care, the social equity of interventions has been sparsely investigated. Objective We aim to investigate whether the efficacy of computer-based versus in-person delivered BAIs is moderated by the participants’ socioeconomic status (ie, to identify whether general hospital patients with low-level education and unemployed patients may benefit more or less from one or the other way of delivery compared to patients with higher levels of education and those that are employed). Methods Patients with nondependent at-risk alcohol use were identified through systematic offline screening conducted on 13 general hospital wards. Patients were approached face-to-face and asked to respond to an app for self-assessment provided by a mobile device. In total, 961 (81% of eligible participants) were randomized and received their allocated intervention: computer-generated and individually tailored feedback letters (CO), in-person counseling by research staff trained in motivational interviewing (PE), or assessment only (AO). CO and PE were delivered on the ward and 1 and 3 months later, were based on the transtheoretical model of intentional behavior change and required the assessment of intervention data prior to each intervention. In CO, the generation of computer-based feedback was created automatically. The assessment of data and sending out feedback letters were assisted by the research staff. Of the CO and PE participants, 89% (345/387) and 83% (292/354) received at least two doses of intervention, and 72% (280/387) and 54% (191/354) received all three doses of intervention, respectively. The outcome was change in grams of pure alcohol per day after 6, 12, 18, and 24 months, with the latter being the primary time-point of interest. Follow-up interviewers were blinded. Study group interactions with education and employment status were tested as predictors of change in alcohol use using latent growth modeling. Results The efficacy of CO and PE did not differ by level of education (P=.98). Employment status did not moderate CO efficacy (Ps≥.66). Up to month 12 and compared to employed participants, unemployed participants reported significantly greater drinking reductions following PE versus AO (incidence rate ratio 0.44, 95% CI 0.21-0.94; P=.03) and following PE versus CO (incidence rate ratio 0.48, 95% CI 0.24–0.96; P=.04). After 24 months, these differences were statistically nonsignificant (Ps≥.31). Conclusions Computer-based and in-person BAI worked equally well independent of the patient’s level of education. Although findings indicate that in the short-term, unemployed persons may benefit more from BAI when delivered in-person rather than computer-based, the findings suggest that both BAIs have the potential to work well among participants with low socioeconomic status. Trial Registration ClinicalTrials.gov NCT01291693; https://clinicaltrials.gov/ct2/show/NCT01291693

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Sick days in general hospital patients two years after brief alcohol intervention: Secondary outcomes from a randomized controlled trial

Cited by 10 publications

References 47 publications

Effects of a brief alcohol intervention addressing the full spectrum of drinking in an adult general population sample: a randomized controlled trial

Effects of a brief alcohol intervention addressing the full spectrum of drinking in an adult general population sample: a randomized controlled trial

Proactive automatised lifestyle intervention (PAL) in general hospital patients: study protocol of a single-group trial

Social Equity in the Efficacy of Computer-Based and In-Person Brief Alcohol Interventions Among General Hospital Patients With At-Risk Alcohol Use: A Randomized Controlled Trial

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