Emergency department screening and intervention for patients with alcohol-related disorders: a pilot study.
BACKGROUND
Physicians in emergency departments (EDs) treat more patients with alcohol-related disorders than do those in primary care settings.


OBJECTIVE
To implement an effective screening, brief intervention, and referral (SBIR) program for use in EDs. Further, to evaluate the impact of the program on alcohol-consumption levels.


METHODS
A prospective cohort pilot study was conducted at a suburban community teaching hospital using a convenience sample of ED patients and an original seven-question screening tool based on well-known guidelines. Subjects screening positive for possible alcohol abuse were given treatment referrals. Follow-up telephone interviews were conducted 6 months later.


RESULTS
Of the 1556 enrolled subjects, 251 (16%) were classified as at-risk drinkers. Seventy-nine at-risk subjects (32% [95% CI, 26%-37%]) screened positive on CAGE-based questions (Cut down, Annoyed, Guilty, Eye opener). At follow-up, 20 (25% [95% CI, 16%-35%]) were successfully contacted. Of these 20 subjects, 5 (25%) refused to participate in follow-up screening. For the remaining 15 individuals, follow-up screening indicated that the mean (SD) number of drinks consumed per week decreased from 28 (14) on study enrollment to 10 (10) at 6-month follow-up (P<.001). Maximum number of drinks per occasion decreased from 12 (8) at enrollment to 6 (7) on follow-up (P=.008). Subject scores on the CAGE-based questions decreased from pre- to postintervention, though not significantly, with an average of 2.1 (1) affirmative answers on enrollment and 1.5 (1.4) at follow-up (P=.108).


CONCLUSIONS
Implementation of an effective SBIR program for alcohol-related disorders can be accomplished in the ED.
Love
Aaron Craig
AC
7437 Beaver Valley Rd, Prescott Valley, AZ 86314-1412, USA. alove1@mac.com
Greenberg
Marna Rayl
MR
Brice
Matthew
M
Weinstock
Michael
M
D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000628:therapy*; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care; D010414:Pennsylvania; D010865:Pilot Projects; D011446:Prospective Studies