Screening and brief intervention for substance misuse among patients with traumatic brain injury.
BACKGROUND
Research on screening and brief interventions (SBI) for substance misuse has demonstrated efficacy in a variety of medical settings including emergency departments and trauma centers. However, SBI has not yet been evaluated for persons who incur traumatic brain injury (TBI)-a substantial patient subpopulation for whom substance-related problems are frequent. To examine whether research on SBI efficacy and effectiveness can be generalized to persons with TBI, a systematic review of the literature was conducted to analyze how TBI populations were included in previous studies and whether there was evidence of differential outcomes.


METHODS
Peer-reviewed studies that investigated SBI for misuse of alcohol or other drugs, that were implemented in emergency departments or trauma centers, and that were published in English since 1985 were examined. From 174 articles initially identified, 28 studies were determined to meet inclusion criteria.


RESULTS
The review revealed that research conducted on SBI for injury populations systematically neglected patients with more severe TBI and those who presented with sufficient confusion that they could not provide informed consent.


CONCLUSIONS
Future effectiveness studies should examine barriers to routine clinical use of SBI and evaluate the generalizability of expected benefits to the full spectrum of injured patients. Researchers should also develop and evaluate systematic accommodations for persons with neurobehavioral impairments who would benefit from brief interventions for substance misuse.
Corrigan
John D
JD
Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus, Ohio 43210, USA. corrigan.1@osu.edu
Bogner
Jennifer
J
Hungerford
Daniel W
DW
Schomer
Katherine
K
D001930:Brain Injuries / Q000150:complications* / Q000523:psychology; D003244:Consciousness Disorders / Q000150:complications; D004636:Emergency Service, Hospital; D006801:Humans; D007258:Informed Consent; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis*