The Effect of Computerized Tailored Brief Advice on At-risk Drinking in Subcritically Injured Trauma Patients

Neumann, Tim; Neuner, Bruno; Weiß-Gerlach, Edith; Tønnesen, Hanne; Gentilello, Larry M.; Wernecke, Klaus D.; Schmidt, Karl‐Hermann; Schröder, Torsten; Wauer, Helmar; Heinz, Andreas; Mann, Karl; Müller, J. M.; Haas, Norbert; Kox, Wolfgang J.; Spies, Claudia

doi:10.1097/01.ta.0000196399.29893.52

Cited by 141 publications

(173 citation statements)

References 35 publications

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“…In 11 trials rated as low to moderate risk of bias that used 14 comparisons (37-39, 48-55), e-interventions were associated with a small, statistically significant reduction in alcohol consumption at 6-month follow-up (MD, −11. Drinking Limit Guidelines-In 4 trials that reported proportion of participants meeting drinking limit guidelines at 6 months (40,43,44,57), including 2 trials rated as high risk of bias, e-interventions had no statistically significant effect on meeting guidelines (risk ratio, …”

Section: E-intervention Characteristics and Supportmentioning

confidence: 99%

Electronic Interventions for Alcohol Misuse and Alcohol Use Disorders

et al. 2015

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Section: E-intervention Characteristics and Supportmentioning

confidence: 99%

Electronic Interventions for Alcohol Misuse and Alcohol Use Disorders

et al. 2015

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“…Screening was conducted with CASI, which has been cited as effective and user friendly. 7,8 This study is limited in that screening all adult trauma patients was attempted, but only 47% actually received an SBI. Although patient characteristics played a role, the most common reasons for not receiving CASI were patients being missed before discharge in the ED (46%) and being missed before discharge from the inpatient units (26%).…”

Section: Discussionmentioning

confidence: 99%

“…9 In a case-control study, patients who received CASI were significantly less likely to report at-risk drinking behavior compared with patients without an intervention (p ϭ 0.008), and they significantly decreased their alcohol intake (p ϭ 0.006) at 6-month follow-up. 8 A study that surveyed CASI respondents in Spanish and English found that 98% of patients found the system easy to use and 75% preferred CASI over a provider-delivered SBI. 7 The American College of Surgeons Committee on Trauma mandated in 2006 that all level 1 and level 2 trauma centers develop a protocol for administering SBI.…”

Section: 2mentioning

confidence: 99%

“…5,6 Recently, a computerized alcohol screening and intervention (CASI) system has been shown to be user friendly, preferred by patients over a provideradministered SBI, and effective at reducing hazardous drinking behavior. 7,8 CASI uses the 10-question Alcohol Use Identification Test (AUDIT) to determine drinking behavior, and its utility has been well investigated. 9 In a case-control study, patients who received CASI were significantly less likely to report at-risk drinking behavior compared with patients without an intervention (p ϭ 0.008), and they significantly decreased their alcohol intake (p ϭ 0.006) at 6-month follow-up.…”

Section: 2mentioning

confidence: 99%

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Predictors of Hazardous Drinking Behavior in 1,340 Adult Trauma Patients: A Computerized Alcohol Screening and Intervention Study

Ewing

Barrios

Lau

et al. 2012

Journal of the American College of Surgeons

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BACKGROUND: Alcohol screening and brief intervention (SBI) is used to decrease alcohol consumption, health care costs, and injury recidivism in trauma patients. Despite SBI being mandated for trauma centers, various concerns have led many centers to conduct SBI only on patients with a detectable blood alcohol concentration (BAC). We sought to determine the predictive nature of BAC on hazardous drinking behavior. STUDY DESIGN: Adult trauma patients were included if they received an SBI before discharge. SBI was administered using a computerized alcohol screening and intervention (CASI) system with the Alcohol Use Disorder Identification Test (AUDIT). Data regarding demographics, injuries, and BAC were prospectively collected. Multivariate analyses were performed to identify independent predictors of hazardous drinking behavior.

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“…Another ED study found that individuals contemplating changing reported poorer outcomes at 6-month follow-up compared with individuals in the precontemplation or action stages of change (Neumann et al, 2006). Walton et al (2008) did not fi nd any relationship between pretreatment levels of change and intervention outcomes over time (baseline to 12-month follow-up).…”

Section: Abstract Objectivementioning

confidence: 99%

Change Plan as an Active Ingredient of Brief Motivational Interventions for Reducing Negative Consequences of Drinking in Hazardous Drinking Emergency-Department Patients

Lee¹,

Baird²,

Longabaugh³

et al. 2010

J. Stud. Alcohol Drugs

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ABSTRACT. Objective:Few studies have examined the effects of brief motivational intervention components, such as change-plan completion, on treatment outcomes. This secondary analysis of an opportunistically recruited emergency-department sample of hazardous injured drinkers examines the potential predictive role of an alcohol-related change plan on treatment outcomes after accounting for pretreatment readiness. Written change plans were independently rated. Method: A mediational analysis framework tested directional hypotheses between pretreatment readiness, change plan, and treatment outcomes using linear regressions. The baseline total Drinker Inventory of Consequences (DrInC) score was covaried on 12-month DrInC total score, in all analyses. Participants who completed a brief motivational intervention and a change plan were included (N = 333). Results: Pretreatment readiness was negatively associated with alcohol consequences at 12 months, = -.09, t(254) = -2.07, p < .05, and good-quality change plans, = .18, t(320) = 4.37, p < .001. With change plan and readiness in the same model, the relationship between readiness and treatment outcomes became nonsignifi cant, but change plan remained a signifi cant predictor of treatment outcomes in the expected direction, = -.17, t(254) = -2.89, p < .01. Follow-up generalized linear modeling including an interaction term (change plan and pretreatment readiness) revealed that those with high readiness and a good-quality change plan versus those with low readiness and a poor-quality change plan had better-than-predicted outcomes for either readiness or change plan alone. Conclusions: Study fi ndings suggest that the change plan in brief motivational intervention may be an active ingredient of treatment associated with better outcomes over and above the infl uence of pretreatment readiness. (J. Stud. Alcohol Drugs, 71, 726-733, 2010) (Burke et al., 2003;Hettema et al., 2005) and in diverse health care settings, including primary care and emergency departments (EDs;Gentilello et al., 1999;Longabaugh et al., 2001;Monti et al., 1999). The underlying principles of MI-valuing patient autonomy, collaboration, eliciting the patient's perspectives, building intrinsic motivation to change, and highlighting the discrepancy between where the patient is and where he or she wants to go-are key to its successful implementation, such that in their absence it is unlikely that MI is being delivered (Miller, 1996;Miller and Rollnick, 2002). Brief motivational interventions (BMIs) are an adaptation of MI and its principles and are predominantly used in medical or health care settings targeting a non-treatment-seeking population (Moyer et al., 2002;Rollnick et al., 1992;Saunders et al., 1995). Although BMIs are informed by MI principles, they are distinct from MI because they are more time limited (usually single session) and may include structured strategies, or treatment components, such as the use of personal feedback reports, discussion of pros and cons of use, and change-plan compl...

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The Effect of Computerized Tailored Brief Advice on At-risk Drinking in Subcritically Injured Trauma Patients

Abstract: The computer-generated intervention was associated with a significant decrease in alcohol use and at-risk drinking. Research is needed to further evaluate and adapt information technology to provide preventive clinical services in the ED.

Cited by 141 publications

References 35 publications

Electronic Interventions for Alcohol Misuse and Alcohol Use Disorders

Electronic Interventions for Alcohol Misuse and Alcohol Use Disorders

Predictors of Hazardous Drinking Behavior in 1,340 Adult Trauma Patients: A Computerized Alcohol Screening and Intervention Study

Change Plan as an Active Ingredient of Brief Motivational Interventions for Reducing Negative Consequences of Drinking in Hazardous Drinking Emergency-Department Patients

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