DIAL: a telephone brief intervention for high-risk alcohol use with injured emergency department patients.
OBJECTIVE
Brief interventions for high-risk alcohol use for injured emergency department (ED) patients have demonstrated effectiveness and may have a more pronounced effect with motor vehicle crash patients. We report on 3-month outcome data of a randomized controlled trial of injured patients, using a novel model of telephone-delivered brief interventions after ED discharge.


METHODS
ED research assistants recruited adult injured patients who screened positive for high-risk alcohol use and were to be discharged home. After discharge, participants received by telephone an assessment of alcohol use and impaired driving and then were randomized to treatment (n=140) or standard care (n=145). Treatment consisted of 2 sessions of brief interventions done by telephone, focusing on risky alcohol use. At 3 months, both groups had an assessment of alcohol use and impaired driving.


RESULTS
Two hundred eighty-five patients were randomized and had a baseline mean Alcohol Use Disorders Inventory Test (AUDIT) score of 11.0 (SD=7.4). Three-month follow-up assessments were completed on 273 (95%). Mean AUDIT score decreased in both the treatment (mean change=-3.4; 95% confidence interval [CI] -4.5 to -2.3) and standard care group (mean change=-3.2; 95% CI -4.2 to -2.2). Measures of impaired driving decreased for the treatment group (mean change=-1.4 95%; CI -3.0 to 0.2) compared with standard care group (mean change=1.0; 95% CI -0.9 to 2.9; P=.04; d=0.31). Participants were stratified post hoc into 3 groups by baseline alcohol problem, with the treatment effect only being in the highest-scoring group (d=.30).


CONCLUSIONS
Telephone brief interventions decreased impaired driving in our treatment group. Telephone brief intervention appears to offer an alternative mechanism to deliver brief intervention for alcohol in this at-risk ED population.
Mello
Michael J
MJ
Injury Prevention Center at Rhode Island Hospital, Department of Emergency Medicine, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA. mjmello@lifespan.org
Longabaugh
Richard
R
Baird
Janette
J
Nirenberg
Ted
T
Woolard
Robert
R
D000063:Accidents, Traffic / Q000517:prevention & control*; D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D000704:Analysis of Variance; D001334:Automobile Driving; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D013689:Telephone