Citation

Mello MJ, Longabaugh R, Baird J, Nirenberg T, Woolard R. Ann. Emerg. Med. 2008; 51(6): 755-764.

Affiliation

Injury Prevention Center at Rhode Island Hospital, Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI.

Copyright

(Copyright © 2008, American College of Emergency Physicians, Publisher Elsevier Publishing)

DOI

10.1016/j.annemergmed.2007.11.034

PMID

18436341

Abstract

STUDY OBJECTIVE: Brief interventions for high-risk alcohol use for injured emergency department (ED) patients have demonstrated effectiveness and may have a more pronounced effect with motor vehicle crash patients. We report on 3-month outcome data of a randomized controlled trial of injured patients, using a novel model of telephone-delivered brief interventions after ED discharge. METHODS: ED research assistants recruited adult injured patients who screened positive for high-risk alcohol use and were to be discharged home. After discharge, participants received by telephone an assessment of alcohol use and impaired driving and then were randomized to treatment (n=140) or standard care (n=145). Treatment consisted of 2 sessions of brief interventions done by telephone, focusing on risky alcohol use. At 3 months, both groups had an assessment of alcohol use and impaired driving. RESULTS: Two hundred eighty-five patients were randomized and had a baseline mean Alcohol Use Disorders Inventory Test (AUDIT) score of 11.0 (SD=7.4). Three-month follow-up assessments were completed on 273 (95%). Mean AUDIT score decreased in both the treatment (mean change=-3.4; 95% confidence interval [CI] -4.5 to -2.3) and standard care group (mean change=-3.2; 95% CI -4.2 to -2.2). Measures of impaired driving decreased for the treatment group (mean change=-1.4 95%; CI -3.0 to 0.2) compared with standard care group (mean change= 1.0; 95%CI -0.9 to 2.9; P= .04; d= 0.31). Participants were stratified post hoc into 3 groups bybaseline alcohol problem, with the treatment effect only being in the highest-scoring group (d= .30). CONCLUSION: Telephone brief interventions decreased impaired driving in ourtreatment group. Telephone brief intervention appears to offer an alternative mechanism to deliverbrief intervention for alcohol in this at-riskED population.

Language: en