title: Six-month follow-up of computerized alcohol screening, brief intervention, and referral to treatment in the emergency department.
abstract: The goal of this observational study was to measure change in alcohol consumption at 6 months following emergency department computerized alcohol screening brief intervention (CASI) and referral to treatment (ED-SBIRT) with integrated brief negotiated interview (BNI) and computer-generated personal alcohol reduction plans. At-risk patients received a BNI by CASI, including personalized feedback, assessment of readiness to change, reasons for cutting down, goal setting, and a printed personal alcohol reduction plan. Alcohol use was assessed by telephone interview 6 months after CASI. Factors associated with lower alcohol consumption were examined. Of the 385 participants who completed the BNI, were consented, and enrolled, 221 subjects completed the 6-month follow-up interview. Forty-seven percent of the study sample of at-risk patients were no longer drinking over the National Institute on Alcohol Abuse and Alcoholism (NIAAA)-recommended limits. Reductions were greater for patients with Alcohol Use Disorders Identification Test (AUDIT) scores of 1 to 7. Readiness to change was a good predictor of drinking below the recommended limits. The use of computerized ED-SBIRT with integrated personalized messaging and BNI holds promise as a viable screening and intervention modality for a wide range of emergency department patients.
authors.affiliation: Center for Trauma and Injury Prevention Research, Department of Emergency Medicine, University of California, Irvine, School of Medicine, Orange, California, USA. federico.vaca@yale.edu
authors.forename: Federico E
authors.initials: FE
authors.lastname: Vaca
authors.forename: Diane
authors.initials: D
authors.lastname: Winn
authors.forename: Craig L
authors.initials: CL
authors.lastname: Anderson
authors.forename: Doug
authors.initials: D
authors.lastname: Kim
authors.forename: Mauricio
authors.initials: M
authors.lastname: Arcila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000628:therapy*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011614:Psychotherapy, Brief / Q000379:methods*; D012017:Referral and Consultation; D015813:Substance Abuse Detection / Q000379:methods*; D013813:Therapy, Computer-Assisted / Q000379:methods*