Colin Drummond
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
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
Professor Thomas Phillips Thomas.Phillips@hull.ac.uk
Professor of Nursing (Addictions)
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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