A randomized controlled trial of different methods of alcohol screening and brief intervention in routine accident and emergency department care: 12-month outcomes

Paolo Deluca, Colin Drummond, Simon Coulton, Eileen Kaner, Dorothy Newbury-Birch, Tom Philips, Katherine Perryman, Nick Heather, Christine Godfrey

    Research output: Contribution to journalMeeting Abstract

    76 Downloads (Pure)

    Abstract

    There is a wealth of evidence on the detrimental impact of excessive alcohol consumption on physical, psychological, and social health. There also exists a substantial evidence base for the efficacy of alcohol brief intervention (BI) aimed at reducing consumption across a range of settings. Research conducted in emergency departments (EDs) has reinforced the current evidence regarding the potential effectiveness and cost-effectiveness of BI. However, the majority of this research has been conducted in a single center, and there is little evidence of the generalizability of SBI implementation across EDs. This pragmatic cluster randomized controlled trial randomized nine EDs to a combination of screening tools (the Modified Single Alcohol Screening Question [M-SASQ], the Fast Alcohol Screening Test [FAST], or the Screening and Intervention Program for Sensible Drinking modified Paddington Alcohol Test [SIPS-PAT]) and interventions (patient intervention leaflet [PIL], brief advice [BA], or brief lifestyle counseling [BLC]). The primary hypothesis was that BLC delivered by an alcohol health worker would be more effective than BA or PIL delivered by ED staff. Outcomes were assessed at six and 12 months. Overall, 5992 patients were screened for eligibility in 9 EDs; of these, 3737 (62%) were found eligible, and 1491 screened positive for an alcohol use disorder (40%). Of those who screened positive, 1204 (81%) consented to participate in the trial. The mean age of participants was 35 years, and the mean AUDIT score at baseline was 12.4. The majority of the sample was male (65%) and white (88%). At 12 months, 803 (67%) of participants were followed up. No significant differences in follow-up rates were observed between intervention groups. Overall, the proportion of participants positive for an alcohol use disorder reduced significantly by 16.3%. This reflected a significant decrease of 18.8% in the PIL group and 15.1% in both the BLC and BA groups. An adjusted logistic regression model found no significant effects of intervention group, screening approach, or baseline AUDIT score.
    Original languageEnglish
    Article numberA80
    JournalAddiction science & clinical practice
    Volume7
    Issue number(Suppl 1)
    DOIs
    Publication statusPublished - 9 Oct 2012

    Fingerprint

    Emergency Medical Services
    Hospital Emergency Service
    Randomized Controlled Trials
    Alcohols
    Life Style
    Counseling
    Logistic Models
    Health
    Research
    Alcohol Drinking
    Drinking
    Cost-Benefit Analysis
    Psychology

    Cite this

    Deluca, Paolo ; Drummond, Colin ; Coulton, Simon ; Kaner, Eileen ; Newbury-Birch, Dorothy ; Philips, Tom ; Perryman, Katherine ; Heather, Nick ; Godfrey, Christine. / A randomized controlled trial of different methods of alcohol screening and brief intervention in routine accident and emergency department care: 12-month outcomes. In: Addiction science & clinical practice. 2012 ; Vol. 7, No. (Suppl 1).
    @article{ff235fadf0dc44fcb736545ac7ff3e79,
    title = "A randomized controlled trial of different methods of alcohol screening and brief intervention in routine accident and emergency department care: 12-month outcomes",
    abstract = "There is a wealth of evidence on the detrimental impact of excessive alcohol consumption on physical, psychological, and social health. There also exists a substantial evidence base for the efficacy of alcohol brief intervention (BI) aimed at reducing consumption across a range of settings. Research conducted in emergency departments (EDs) has reinforced the current evidence regarding the potential effectiveness and cost-effectiveness of BI. However, the majority of this research has been conducted in a single center, and there is little evidence of the generalizability of SBI implementation across EDs. This pragmatic cluster randomized controlled trial randomized nine EDs to a combination of screening tools (the Modified Single Alcohol Screening Question [M-SASQ], the Fast Alcohol Screening Test [FAST], or the Screening and Intervention Program for Sensible Drinking modified Paddington Alcohol Test [SIPS-PAT]) and interventions (patient intervention leaflet [PIL], brief advice [BA], or brief lifestyle counseling [BLC]). The primary hypothesis was that BLC delivered by an alcohol health worker would be more effective than BA or PIL delivered by ED staff. Outcomes were assessed at six and 12 months. Overall, 5992 patients were screened for eligibility in 9 EDs; of these, 3737 (62{\%}) were found eligible, and 1491 screened positive for an alcohol use disorder (40{\%}). Of those who screened positive, 1204 (81{\%}) consented to participate in the trial. The mean age of participants was 35 years, and the mean AUDIT score at baseline was 12.4. The majority of the sample was male (65{\%}) and white (88{\%}). At 12 months, 803 (67{\%}) of participants were followed up. No significant differences in follow-up rates were observed between intervention groups. Overall, the proportion of participants positive for an alcohol use disorder reduced significantly by 16.3{\%}. This reflected a significant decrease of 18.8{\%} in the PIL group and 15.1{\%} in both the BLC and BA groups. An adjusted logistic regression model found no significant effects of intervention group, screening approach, or baseline AUDIT score.",
    author = "Paolo Deluca and Colin Drummond and Simon Coulton and Eileen Kaner and Dorothy Newbury-Birch and Tom Philips and Katherine Perryman and Nick Heather and Christine Godfrey",
    year = "2012",
    month = "10",
    day = "9",
    doi = "10.1186/1940-0640-7-S1-A80",
    language = "English",
    volume = "7",
    journal = "Addiction science & clinical practice",
    issn = "1940-0632",
    publisher = "BioMed Central Ltd.",
    number = "(Suppl 1)",

    }

    A randomized controlled trial of different methods of alcohol screening and brief intervention in routine accident and emergency department care: 12-month outcomes. / Deluca, Paolo; Drummond, Colin; Coulton, Simon; Kaner, Eileen; Newbury-Birch, Dorothy; Philips, Tom; Perryman, Katherine; Heather, Nick; Godfrey, Christine.

    In: Addiction science & clinical practice, Vol. 7, No. (Suppl 1), A80, 09.10.2012.

    Research output: Contribution to journalMeeting Abstract

    TY - JOUR

    T1 - A randomized controlled trial of different methods of alcohol screening and brief intervention in routine accident and emergency department care: 12-month outcomes

    AU - Deluca, Paolo

    AU - Drummond, Colin

    AU - Coulton, Simon

    AU - Kaner, Eileen

    AU - Newbury-Birch, Dorothy

    AU - Philips, Tom

    AU - Perryman, Katherine

    AU - Heather, Nick

    AU - Godfrey, Christine

    PY - 2012/10/9

    Y1 - 2012/10/9

    N2 - There is a wealth of evidence on the detrimental impact of excessive alcohol consumption on physical, psychological, and social health. There also exists a substantial evidence base for the efficacy of alcohol brief intervention (BI) aimed at reducing consumption across a range of settings. Research conducted in emergency departments (EDs) has reinforced the current evidence regarding the potential effectiveness and cost-effectiveness of BI. However, the majority of this research has been conducted in a single center, and there is little evidence of the generalizability of SBI implementation across EDs. This pragmatic cluster randomized controlled trial randomized nine EDs to a combination of screening tools (the Modified Single Alcohol Screening Question [M-SASQ], the Fast Alcohol Screening Test [FAST], or the Screening and Intervention Program for Sensible Drinking modified Paddington Alcohol Test [SIPS-PAT]) and interventions (patient intervention leaflet [PIL], brief advice [BA], or brief lifestyle counseling [BLC]). The primary hypothesis was that BLC delivered by an alcohol health worker would be more effective than BA or PIL delivered by ED staff. Outcomes were assessed at six and 12 months. Overall, 5992 patients were screened for eligibility in 9 EDs; of these, 3737 (62%) were found eligible, and 1491 screened positive for an alcohol use disorder (40%). Of those who screened positive, 1204 (81%) consented to participate in the trial. The mean age of participants was 35 years, and the mean AUDIT score at baseline was 12.4. The majority of the sample was male (65%) and white (88%). At 12 months, 803 (67%) of participants were followed up. No significant differences in follow-up rates were observed between intervention groups. Overall, the proportion of participants positive for an alcohol use disorder reduced significantly by 16.3%. This reflected a significant decrease of 18.8% in the PIL group and 15.1% in both the BLC and BA groups. An adjusted logistic regression model found no significant effects of intervention group, screening approach, or baseline AUDIT score.

    AB - There is a wealth of evidence on the detrimental impact of excessive alcohol consumption on physical, psychological, and social health. There also exists a substantial evidence base for the efficacy of alcohol brief intervention (BI) aimed at reducing consumption across a range of settings. Research conducted in emergency departments (EDs) has reinforced the current evidence regarding the potential effectiveness and cost-effectiveness of BI. However, the majority of this research has been conducted in a single center, and there is little evidence of the generalizability of SBI implementation across EDs. This pragmatic cluster randomized controlled trial randomized nine EDs to a combination of screening tools (the Modified Single Alcohol Screening Question [M-SASQ], the Fast Alcohol Screening Test [FAST], or the Screening and Intervention Program for Sensible Drinking modified Paddington Alcohol Test [SIPS-PAT]) and interventions (patient intervention leaflet [PIL], brief advice [BA], or brief lifestyle counseling [BLC]). The primary hypothesis was that BLC delivered by an alcohol health worker would be more effective than BA or PIL delivered by ED staff. Outcomes were assessed at six and 12 months. Overall, 5992 patients were screened for eligibility in 9 EDs; of these, 3737 (62%) were found eligible, and 1491 screened positive for an alcohol use disorder (40%). Of those who screened positive, 1204 (81%) consented to participate in the trial. The mean age of participants was 35 years, and the mean AUDIT score at baseline was 12.4. The majority of the sample was male (65%) and white (88%). At 12 months, 803 (67%) of participants were followed up. No significant differences in follow-up rates were observed between intervention groups. Overall, the proportion of participants positive for an alcohol use disorder reduced significantly by 16.3%. This reflected a significant decrease of 18.8% in the PIL group and 15.1% in both the BLC and BA groups. An adjusted logistic regression model found no significant effects of intervention group, screening approach, or baseline AUDIT score.

    U2 - 10.1186/1940-0640-7-S1-A80

    DO - 10.1186/1940-0640-7-S1-A80

    M3 - Meeting Abstract

    VL - 7

    JO - Addiction science & clinical practice

    JF - Addiction science & clinical practice

    SN - 1940-0632

    IS - (Suppl 1)

    M1 - A80

    ER -