title: The hospital outpatient alcohol project (HOAP): protocol for an individually randomized, parallel-group superiority trial of electronic alcohol screening and brief intervention versus screening alone for unhealthy alcohol use.
abstract: BACKGROUND
  Electronic screening and brief intervention (e-SBI) is a promising alternative to screening and brief intervention by health-care providers, but its efficacy in the hospital outpatient setting, which serves a large proportion of the population, has not been established. The aim of this study is to estimate the effect of e-SBI in hospital outpatients with hazardous or harmful drinking.
  
  
  METHODS
  This randomized controlled trial will be conducted in the outpatient department of a large tertiary referral hospital in Newcastle (population 540,000), Australia. Some 772 adults with appointments at a broad range of medical and surgical outpatient clinics who score 5-9 inclusive on the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) subscale will be randomly assigned in a 1:1 ratio to electronic alcohol screening alone (control) or to e-SBI. As randomization will be effected by computer, researchers and participants (who will be invited to participate in a study of alcohol use over time) will be blinded to group assignment. The primary analysis will be based on the intention-to-treat principle and compare weekly volume (grams of alcohol) and the full AUDIT score with a six-month reference period between the groups six months post randomization. Secondary outcomes, assessed six and 12 months after randomization, will include drinking frequency, typical occasion quantity, proportion who report binge drinking, proportion who report heavy drinking, and health-care utilization.
  
  
  CONCLUSIONS
  If e-SBI is efficacious in outpatient settings, it offers the prospect of systematically and sustainably reaching a large number of hazardous and harmful drinkers, many of whom do not otherwise seek or receive help.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12612000905864.
authors.affiliation: School of Medicine and Public Health, University of Newcastle, Level 4 West, HMRI Building, University Drive, Newcastle, Callaghan NSW 2308, Australia. natalie.johnson@newcastle.edu.au.
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Johnson
authors.forename: Kypros
authors.initials: K
authors.lastname: Kypri
authors.forename: John B
authors.initials: JB
authors.lastname: Saunders
authors.forename: Richard
authors.initials: R
authors.lastname: Saitz
authors.forename: John
authors.initials: J
authors.lastname: Attia
authors.forename: Adrian
authors.initials: A
authors.lastname: Dunlop
authors.forename: Christopher
authors.initials: C
authors.lastname: Doran
authors.forename: Patrick
authors.initials: P
authors.lastname: McElduff
authors.forename: Luke
authors.initials: L
authors.lastname: Wolfenden
authors.forename: Jim
authors.initials: J
authors.lastname: McCambridge
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000628:therapy*; D001315:Australia; D006801:Humans; D008403:Mass Screening / Q000458:organization & administration*; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D062606:Tertiary Care Centers / Q000458:organization & administration