A controlled trial of brief intervention versus brief advice for at-risk drinking trauma center patients.
BACKGROUND
Numerous reports document that preinjury alcohol use is associated with all modes of injury requiring treatment in a trauma center, with 25% to 50% or more of patients testing positive for alcohol at the time of admission. There is evidence that in trauma patients unaddressed alcohol use problems result in recurrent injury requiring readmission to a trauma center and/or death.


METHODS
A randomized clinical trial was conducted to assess the effectiveness of two types of brief interventions to reduce drinking and the consequences of drinking. Trauma patients defined as at-risk alcohol users (n=497) were randomized into two treatment options: a brief personalized motivational intervention (PMI), or brief information and advice (BIA). After a brief assessment, PMI subjects received a motivational session, feedback letter, and two postdischarge telephone contacts, whereas the BIA group received a brochure and one postdischarge telephone contact. Both groups were reassessed at 6 and 12 months postinjury.


RESULTS
Both the PMI and BIA groups had statistically significant reductions in drinking, binge episodes, and consequences related to drinking that persisted from the 6- to the 12-month follow-up. However, although not statistically significant, for those classified as lower-level drinkers (<or=1 drink per day), there was a consistent pattern of maintaining reductions for the PMI group at 12 months compared with the BIA group.


CONCLUSIONS
Our results suggest that brief interventions (PMI and BIA) that link alcohol consumption with trauma injury and consequences of drinking can be effective in reducing drinking and consequences related to drinking in a significant portion of at-risk nondependent drinkers.
Soderstrom
Carl A
CA
National Center for Trauma and EMS, Department of Epidemiology, University of Maryland School of Medicine, Baltimore, USA. csoderstrom@umm.edu
DiClemente
Carlo C
CC
Dischinger
Patricia C
PC
Hebel
J Richard
JR
McDuff
David R
DR
Auman
Kimberly Mitchell
KM
Kufera
Joseph A
JA
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000517:prevention & control*; D037001:Directive Counseling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011614:Psychotherapy, Brief; D012309:Risk-Taking; D014193:Trauma Centers; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000209:etiology / Q000517:prevention & control*