title: A group-based brief intervention for surgery patients with high-risk substance use.
abstract: OBJECTIVE
  This study examined the feasibility and efficacy of a psychosocial intervention to address high-risk substance use in patients scheduled for elective surgery.
  
  
  METHODS
  A group-format intervention, based on motivational interviewing principles, was provided prior to elective surgery to 107 participants with at-risk substance use, identified using the Alcohol Use Disorders Identification Test - Condensed (AUDIT-C) and self-report of illicit drug use. Patient satisfaction was assessed with an anonymous survey. Within-subject comparisons of substance use at baseline and at a postoperative follow-up evaluation were conducted. A control group of 67 surgery patients reporting high-risk substance use completed baseline assessments and received usual care. Medical outcomes and measures of utilization were compared between groups.
  
  
  RESULTS
  Patient satisfaction with the brief intervention was high. A paired t test comparing average pre- and post-AUDIT-C scores showed significant reduction in substance use postsurgery (t = 9.94, P = .000), and participants reported intention to maintain reduced substance use levels. Between-group analyses revealed no significant differences in medical complications or utilization.
  
  
  CONCLUSIONS
  Findings suggest that a group-based intervention for substance use disorder can be implemented as part of preoperative care and may contribute to decreased substance use prior to and following surgery. Further work is needed to identify methods to reduce adverse medical outcomes in surgical patients.
authors.affiliation: W.S. Middleton Memorial Veterans Hospital, Madison, WI; Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin. Electronic address: mary.wyman@va.gov.
authors.forename: Mary F
authors.initials: MF
authors.lastname: Wyman
authors.affiliation: Zablocki Veterans Affairs Medical Center, Milwaukee, WI.
authors.forename: Peter
authors.initials: P
authors.lastname: Kallio
authors.affiliation: Zablocki Veterans Affairs Medical Center, Milwaukee, WI.
authors.forename: Emily
authors.initials: E
authors.lastname: Allred
authors.affiliation: Zablocki Veterans Affairs Medical Center, Milwaukee, WI.
authors.forename: Deborah
authors.initials: D
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000534:rehabilitation*; D002492:Central Nervous System Depressants / Q000009:adverse effects; D017558:Elective Surgical Procedures; D000431:Ethanol / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011614:Psychotherapy, Brief; D011615:Psychotherapy, Group; D013375:Substance Withdrawal Syndrome / Q000209:etiology / Q000517:prevention & control*; D019966:Substance-Related Disorders / Q000534:rehabilitation
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol
keywords: Brief intervention; Health behavior; Substance use disorder; Surgery; Veterans