The effect of referral for brief intervention for alcohol misuse on repetition of deliberate self-harm: an exploratory randomized controlled trial

Crawford, Mike; Csipke, Emese; Reid, Steven; Nilsen, Keith A.; Redhead, Julian; Touquet, Robin

doi:10.1017/s0033291709991899

Cited by 30 publications

(29 citation statements)

References 26 publications

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“…31 Alcohol misuse is an important risk factor for deliberate self-harm. 32 Almost half of those presenting to services after an episode of deliberate self-harm have consumed alcohol in the period prior to the act. 32 Once again, earlier research has indicated that alcohol screenings were unacceptably low for this ED population 6 , yet there has been little change in the rate of alcohol screenings from 1993 to 2008.…”

Section: Discussionmentioning

confidence: 99%

“…32 Almost half of those presenting to services after an episode of deliberate self-harm have consumed alcohol in the period prior to the act. 32 Once again, earlier research has indicated that alcohol screenings were unacceptably low for this ED population 6 , yet there has been little change in the rate of alcohol screenings from 1993 to 2008. The conflicting evidence on the effectiveness of alcohol screenings and interventions in EDs, as well as the unreliability of self-reported alcohol use may be possible explanations for low screening rates.…”

Section: Discussionmentioning

confidence: 99%

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Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993–2008

Ting

Sullivan

Boudreaux

et al. 2012

General Hospital Psychiatry

225

151

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Objective To describe the epidemiology of emergency department (ED) visits for attempted suicide and self-inflicted injury over a 16-year period. Method Data were obtained from the National Hospital Ambulatory Medical Care Survey including all visits for attempted suicide and self-inflicted injury (E950–E959) during 1993–2008. Results Over the 16-year period, there was an average of 420,000 annual ED visits for attempted suicide and self-inflicted injury (1.50 [95% confidence interval (CI) 1.33–1.67] visits per 1,000 US population) and the average annual number for these ED visits more than doubled from 244,000 in 1993–1996 to 538,000 in 2005–2008. During the same timeframe, ED visits for these injuries per 1,000 US population almost doubled for males (0.84 to 1.62), females (1.04 to 1.96), whites (0.94 to 1.82), and blacks (1.14 to 2.10). Visits were most common among ages 15–19 and the number of visits coded as urgent/emergent decreased. Conclusions ED visit volume for attempted suicide and self-inflicted injury has increased over the past two decades in all major demographic groups. Awareness of these longitudinal trends may assist efforts to increase research on suicide prevention. In addition, this information may be used to inform current suicide and self-injury related ED interventions and treatment programs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993–2008

Ting

Sullivan

Boudreaux

et al. 2012

General Hospital Psychiatry

225

151

View full text Add to dashboard Cite

show abstract

“…Early feasibility trials suggested low rates of SBIRT service delivery among patients with a positive alcohol screen, with only 41 to 55% of such patients being offered an intervention (Hungerford, Pollock, & Todd, 2000; Peters, Brooker, McCabe, & Short, 1998). Fortunately, service delivery rates improved substantially in subsequent randomized clinical trials; nonetheless, approximately 11 to 30% of injured patients with a positive alcohol screen who consented to study participation were discharged before interventions could delivered (Blow et al, 2009; Crawford et al, 2010; Gentilello et al, 1999; Roudsari, Caetano, Frankowski, & Field, 2009). Moreover, a major trial evaluating SBIRT services in 14 academic emergency departments in the US revealed that 23.5% of patients with a positive alcohol screen were not enrolled in the trial because they were unable to provide consent or were excluded from the trial based on other clinical characteristics (Academic ED SBIRT Research Collaborative, 2007).…”

Section: Introductionmentioning

confidence: 99%

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

Turner

McCann

Dunn

et al. 2017

Journal of Substance Abuse Treatment

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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.

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“…Thirty-three papers were included in the review [11-13,19-48]; see trial profile in Figure 1. The studies originated from United States (16), United Kingdom (6), Spain (3), Australia (2), Sweden (2), Denmark (1), Finland (1), Germany (1) and Switzerland (1).…”

Section: Resultsmentioning

confidence: 99%

“…Only one study [28] had a one-month follow-up visit and the adherence rate was 62%. The adherence rate after three months was 67% (54-96%) based on ten studies [19,20,22,27,28,35,36,39,40,48], after six months 72% (45-89%) based on 15 studies [11,23-25,27,29,30,33,36-38,41,44,47,48] and 67% (27-92%) after twelve months based on 15 studies [11,23-27,29,30,33,34,37,41,44-46]. …”

Section: Resultsmentioning

confidence: 99%

Will emergency and surgical patients participate in and complete alcohol interventions? A systematic review

et al. 2011

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BackgroundIn the everyday surgical life, staff may experience that patients with Alcohol Use Disorders (AUDs) seem reluctant to participate in alcohol intervention programs. The objective was therefore to assess acceptance of screening and intervention as well as adherence to the intervention program among emergency department (ED) and surgical patients with AUDs.MethodsA systematic literature search was followed by extraction of acceptance and adherence rates in ED and surgical patients. Numbers needed to screen (NNS) were calculated. Subgroup analyses were carried out based on different study characteristics.ResultsThe literature search revealed 33 relevant studies. Of these, 31 were randomized trials, 28 were conducted in EDs and 31 evaluated the effect of brief alcohol intervention. Follow-up was mainly conducted after six and/or twelve months.Four in five ED patients accepted alcohol screening and two in three accepted participation in intervention. In surgical patients, two in three accepted screening and the intervention acceptance rate was almost 100%. The adherence rate was above 60% for up to twelve months in both ED and surgical patients. The NNS to identify one eligible AUD patient and to get one eligible patient to accept participation in alcohol intervention varied from a few up to 70 patients.The rates did not differ between randomized and non-randomized trials, brief and intensive interventions or validated and self-reported alcohol consumption. Adherence rates were not affected by patients' group allocation and type of follow-up.ConclusionsMost emergency and surgical patients with AUD accept participation in alcohol screening and interventions and complete the intervention program.

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The effect of referral for brief intervention for alcohol misuse on repetition of deliberate self-harm: an exploratory randomized controlled trial

Abstract: Referral for brief intervention for alcohol misuse following an episode of DSH may not influence the likelihood of repetition of self-harm. Longer-term interventions may be needed to help people who deliberately harm themselves and have evidence of concurrent alcohol misuse.

Cited by 30 publications

References 26 publications

Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993–2008

Trends in US emergency department visits for attempted suicide and self-inflicted injury, 1993–2008

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

Will emergency and surgical patients participate in and complete alcohol interventions? A systematic review

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