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

Drummond, C, Deluca, P, Myles, J, Patton, R, Perryman, K, Phillips, T, Coulton, S, Bland, M, Dale, V, Godfrey, C, Parrott, S, Cassidy, P, Crawford, M, Gilvarry, E, McGovern, R, Newbury-Birch, D, Kaner, E, Heather, N, Oyefeso, A, Shepherd, J and Touquet, R (2014) The effectiveness of alcohol screening and brief intervention in emergency departments: A multicentre pragmatic cluster randomized controlled trial PLoS ONE, 9 (6).

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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.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Psychology
Authors :
AuthorsEmailORCID
Drummond, CUNSPECIFIEDUNSPECIFIED
Deluca, PUNSPECIFIEDUNSPECIFIED
Myles, JUNSPECIFIEDUNSPECIFIED
Patton, RUNSPECIFIEDUNSPECIFIED
Perryman, KUNSPECIFIEDUNSPECIFIED
Phillips, TUNSPECIFIEDUNSPECIFIED
Coulton, SUNSPECIFIEDUNSPECIFIED
Bland, MUNSPECIFIEDUNSPECIFIED
Dale, VUNSPECIFIEDUNSPECIFIED
Godfrey, CUNSPECIFIEDUNSPECIFIED
Parrott, SUNSPECIFIEDUNSPECIFIED
Cassidy, PUNSPECIFIEDUNSPECIFIED
Crawford, MUNSPECIFIEDUNSPECIFIED
Gilvarry, EUNSPECIFIEDUNSPECIFIED
McGovern, RUNSPECIFIEDUNSPECIFIED
Newbury-Birch, DUNSPECIFIEDUNSPECIFIED
Kaner, EUNSPECIFIEDUNSPECIFIED
Heather, NUNSPECIFIEDUNSPECIFIED
Oyefeso, AUNSPECIFIEDUNSPECIFIED
Shepherd, JUNSPECIFIEDUNSPECIFIED
Touquet, RUNSPECIFIEDUNSPECIFIED
Date : 25 June 2014
Identification Number : 10.1371/journal.pone.0099463
Additional Information : Copyright 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.
Depositing User : Symplectic Elements
Date Deposited : 13 Feb 2015 09:54
Last Modified : 28 Feb 2015 14:34
URI: http://epubs.surrey.ac.uk/id/eprint/806418

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