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Brief interventions to prevent excessive alcohol use in adolescents at low-risk presenting to Emergency Departments: Three-arm, randomised trial of effectiveness and cost-effectiveness

Deluca, Paolo; Coulton, Simon; Alam, Mohammed Fasihul; Boniface, Sadie; Cohen, David; Donoghue, Kim; Gilvarry, Eilish; Kaner, Eileen; Maconochie, Ian; McArdle, Paul; McGovern, Ruth; Newbury-Birch, Dorothy; Patton, Robert; Pellatt-Higgins, Tracy; Phillips, Ceri; Phillips, Thomas; Pockett, Rhys D.; Russell, Ian; Strang, John; Drummond, Colin

Authors

Paolo Deluca

Simon Coulton

Mohammed Fasihul Alam

Sadie Boniface

David Cohen

Kim Donoghue

Eilish Gilvarry

Eileen Kaner

Ian Maconochie

Paul McArdle

Ruth McGovern

Dorothy Newbury-Birch

Robert Patton

Tracy Pellatt-Higgins

Ceri Phillips

Rhys D. Pockett

Ian Russell

John Strang

Colin Drummond



Abstract

© 2021 Background: Alcohol consumption and related harm increase rapidly from the age of 12 years. We evaluated whether alcohol screening and brief intervention is effective and cost-effective in delaying hazardous or harmful drinking amongst low-risk or abstaining adolescents attending Emergency Departments (EDs). Methods: This ten-centre, three-arm, parallel-group, single-blind, pragmatic, individually randomised trial screened ED attenders aged between 14 and 17 years for alcohol consumption. We sampled at random one third of those scoring at most 2 on AUDIT-C who had access to the internet and, if aged under 16, were Gillick competent or had informed consent from parent or guardian. We randomised them between: screening only (control intervention); one session of face-to-face Personalised Feedback and Brief Advice (PFBA); and PFBA plus an electronic brief intervention (eBI) on smartphone or web. We conducted follow-up after six and 12 months. The principal outcomes were alcohol consumed over the 3 months before 12-month follow up, measured by AUDIT-C; and quality-adjusted life-years. Findings: Between October 2014 and May 2015, we approached 5,016 eligible patients of whom 3,326 consented to be screened and participate in the trial; 2,571 of these were low-risk drinkers or abstainers, consuming an average 0.14 units per week. We randomised: 304 to screening only; 285 to PFBA; and 294 to PFBA and eBI. We found no significant difference between groups, notably in weekly alcohol consumption: those receiving screening only drank 0.10 units (95% confidence interval 0.05 to 0.18); PFBA 0.12 (0.06 to 0.21); PFBA and eBI 0.10 (0.05 to 0.19). Interpretation: While drinking levels remained low in this population, this trial found no evidence that PFBA with or without eBI was more effective than screening alone in reducing or delaying alcohol consumption.

Citation

Deluca, P., Coulton, S., Alam, M. F., Boniface, S., Cohen, D., Donoghue, K., …Drummond, C. (in press). Brief interventions to prevent excessive alcohol use in adolescents at low-risk presenting to Emergency Departments: Three-arm, randomised trial of effectiveness and cost-effectiveness. International Journal of Drug Policy, https://doi.org/10.1016/j.drugpo.2021.103113

Journal Article Type Article
Acceptance Date Jan 8, 2021
Online Publication Date Jan 22, 2021
Deposit Date Jan 22, 2021
Publicly Available Date Apr 1, 2021
Journal International Journal of Drug Policy
Print ISSN 0955-3959
Electronic ISSN 1873-4758
Publisher Elsevier
Peer Reviewed Peer Reviewed
Article Number 103113
DOI https://doi.org/10.1016/j.drugpo.2021.103113
Keywords Alcohol; Alcohol screening; Brief intervention; Electronic brief intervention; Adolescent; Low risk; Emergency department; Randomised controlled trial; Effectiveness; Cost-effectiveness
Public URL https://hull-repository.worktribe.com/output/3698550
Publisher URL https://www.sciencedirect.com/science/article/pii/S0955395921000128?via%3Dihub

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