title: Brief intervention for medical inpatients with unhealthy alcohol use: a randomized, controlled trial.
abstract: BACKGROUND
  The efficacy of brief intervention in reducing alcohol consumption is well established for selected outpatients but not for medical inpatients.
  
  
  OBJECTIVE
  To determine whether brief intervention improves alcohol outcomes in medical inpatients who were identified by screening as having unhealthy alcohol use.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  Medical service of an urban hospital.
  
  
  METHODS
  341 medical inpatients who were drinking risky amounts of alcohol (defined for eligibility as >14 drinks/wk or > or =5 drinks/occasion for men and >11 drinks/wk or > or =4 drinks/occasion for women and persons > or =66 y); 77% had alcohol dependence as determined by the Composite International Diagnostic Interview Alcohol Module.
  
  
  METHODS
  A 30-minute session of motivational counseling given by trained counselors during a patient's hospitalization (n = 172) versus usual care (n = 169).
  
  
  METHODS
  Self-reported primary outcomes were receipt of alcohol assistance (for example, alcohol disorders specialty treatment) by 3 months in dependent drinkers and change in the mean number of drinks per day from enrollment to 12 months in all patients.
  
  
  RESULTS
  The intervention was not significantly associated with receipt of alcohol assistance by 3 months among alcohol-dependent patients (adjusted proportions receiving assistance, 49% for the intervention group and 44% for the control group; intervention-control difference, 5% [95% CI, -8% to 19%]) or with drinks per day at 12 months among all patients (adjusted mean decreases, 1.5 for patients who received the intervention and 3.1 for patients who received usual care; adjusted mean group difference, -1.5 [CI, -3.7 to 0.6]). There was no significant interaction between the intervention and alcohol dependence in statistical models predicting drinks per day (P = 0.24).
  
  
  CONCLUSIONS
  Baseline imbalances existed between randomized groups. Patients who received usual care were assessed and advised that they could discuss their drinking with their physicians.
  
  
  CONCLUSIONS
  Brief intervention is insufficient for linking medical inpatients with treatment for alcohol dependence and for changing alcohol consumption. Medical inpatients with unhealthy alcohol use require more extensive, tailored alcohol interventions.
authors.affiliation: Boston Medical Center and Boston University, Boston, Massachusetts 02118, USA. rsaitz@bu.edu
authors.forename: Richard
authors.initials: R
authors.lastname: Saitz
authors.forename: Tibor P
authors.initials: TP
authors.lastname: Palfai
authors.forename: Debbie M
authors.initials: DM
authors.lastname: Cheng
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Horton
authors.forename: Naomi
authors.initials: N
authors.lastname: Freedner
authors.forename: Kim
authors.initials: K
authors.lastname: Dukes
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Kraemer
authors.forename: Mark S
authors.initials: MS
authors.lastname: Roberts
authors.forename: Rosanne T
authors.initials: RT
authors.lastname: Guerriero
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000628:therapy*; D001521:Behavior Therapy; D003376:Counseling; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome