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The effectiveness of alcohol screening and brief intervention in emergency departments: A multicentre pragmatic cluster randomized controlled trial

Drummond, Colin; Deluca, Paolo; Coulton, Simon; Bland, Martin; Cassidy, Paul; Crawford, Mike; Dale, Veronica; Gilvarry, Eilish; Godfrey, Christine; Heather, Nick; McGovern, Ruth; Myles, Judy; Newbury-Birch, Dorothy; Oyefeso, Adenekan; Parrott, Steve; Patton, Robert; Perryman, Katherine; Phillips, Tom; Shepherd, Jonathan; Touquet, Robin; Kaner, Eileen

Authors

Colin Drummond

Paolo Deluca

Simon Coulton

Martin Bland

Paul Cassidy

Mike Crawford

Veronica Dale

Eilish Gilvarry

Christine Godfrey

Nick Heather

Ruth McGovern

Judy Myles

Dorothy Newbury-Birch

Adenekan Oyefeso

Steve Parrott

Robert Patton

Katherine Perryman

Jonathan Shepherd

Robin Touquet

Eileen Kaner



Contributors

Bernard Le Foll
Editor

Abstract

Background: Alcohol misuse is common in people attending emergency departments (EDs) and there is some evidence of efficacy of alcohol screening and brief interventions (SBI). This study investigated the effectiveness of SBI approaches of different intensities delivered by ED staff in nine typical EDs in England: the SIPS ED trial. Methods and Findings: Pragmatic multicentre cluster randomized controlled trial of SBI for hazardous and harmful drinkers presenting to ED. Nine EDs were randomized to three conditions: a patient information leaflet (PIL), 5 minutes of brief advice (BA), and referral to an alcohol health worker who provided 20 minutes of brief lifestyle counseling (BLC). The primary outcome measure was the Alcohol Use Disorders Identification Test (AUDIT) status at 6 months. Of 5899 patients aged 18 or more presenting to EDs, 3737 (63·3%) were eligible to participate and 1497 (40·1%) screened positive for hazardous or harmful drinking, of whom 1204 (80·4%) gave consent to participate in the trial. Follow up rates were 72% (n = 863) at six, and 67% (n = 810) at 12 months. There was no evidence of any differences between intervention conditions for AUDIT status or any other outcome measures at months 6 or 12 in an intention to treat analysis. At month 6, compared to the PIL group, the odds ratio of being AUDIT negative for brief advice was 1·103 (95% CI 0·328 to 3·715). The odds ratio comparing BLC to PIL was 1·247 (95% CI 0·315 to 4·939). A per protocol analysis confirmed these findings. Conclusions: SBI is difficult to implement in typical EDs. The results do not support widespread implementation of alcohol SBI in ED beyond screening followed by simple clinical feedback and alcohol information, which is likely to be easier and less expensive to implement than more complex interventions. Trial Registration: Current Controlled Trials ISRCTN 93681536 © 2014 Drummond et al.

Citation

Drummond, C., Deluca, P., Coulton, S., Bland, M., Cassidy, P., Crawford, M., …Kaner, E. (2014). The effectiveness of alcohol screening and brief intervention in emergency departments: A multicentre pragmatic cluster randomized controlled trial. PLoS ONE, 9(6), e99463. https://doi.org/10.1371/journal.pone.0099463

Journal Article Type Article
Acceptance Date May 12, 2014
Online Publication Date Jun 25, 2014
Publication Date Jun 25, 2014
Deposit Date Jun 8, 2018
Publicly Available Date Mar 28, 2024
Journal PLoS ONE
Print ISSN 1932-6203
Electronic ISSN 1932-6203
Publisher Public Library of Science
Peer Reviewed Peer Reviewed
Volume 9
Issue 6
Article Number e99463
Pages e99463
DOI https://doi.org/10.1371/journal.pone.0099463
Keywords General Biochemistry, Genetics and Molecular Biology; General Agricultural and Biological Sciences; General Medicine
Public URL https://hull-repository.worktribe.com/output/750941
Publisher URL http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0099463

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Copyright Statement
© 2014 Drummond et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.





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