title: Interventions for Increasing Alcohol Treatment Utilization Among Patients with Alcohol Use Disorders from Emergency Departments: A Systematic Review.
abstract: OBJECTIVE
  Alcohol use disorders (AUDs) are characterized by low treatment coverage. Emergency departments (EDs) have great potential to increase alcohol treatment coverage. While ED-based brief interventions (BIs) are rarely effective for reducing alcohol use and related consequences in people with AUDs, utilization of formal alcohol treatment has been demonstrated to be useful. Thus we conducted a systematic review to determine efficacious interventions for increasing subsequent alcohol treatment from EDs.
  
  
  METHODS
  A systematic search of the literature up to 31 December 2013 was undertaken in three electronic databases: PubMed, PsycINFO and The Cochrane Library. Only randomized controlled trials (RCTs), controlled clinical trials (CCTs) and non-randomized controlled trials (NRCTs) were included. A meta-analysis was judged inappropriate because of substantial discrepancies in term of interventions' characteristics across studies.
  
  
  RESULTS
  From the 2182 identified records, 7 studies (4RCTs, 2 CCTs, 1NRCT) met inclusion criteria. Onsite brief advice (BA) was found efficacious in comparison to no active control condition, but no evidence of efficacy was found when compared to active control conditions. Referral to post-discharge BIs was not found efficacious either used alone or in addition to onsite BA. There is evidence, albeit limited, suggesting that more intensive interventions, such as referral to extended post-discharge interventions and onsite extended BI, might be useful.
  
  
  CONCLUSIONS
  Based on the available evidence, onsite BA with leaflets appears to be the minimum level of intervention since it enables to actively intervene while fitting in the time concerns experienced in EDs. Further research is needed to confirm these findings given the limited quantity and quality of existing data and to determine whether more intensive interventions could actually be useful.
authors.affiliation: Service d'Addictologie, CHRU Lille, F-59037 Lille, France; CSAPA, EPSM Val de Lys - Artois, 155 rue d'Annezin, 62400 Béthune, France. Electronic address: SIMIONI.NICOLAS@GMAIL.COM.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Simioni
authors.affiliation: Service d'Addictologie, CHRU Lille, F-59037 Lille, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Rolland
authors.affiliation: Service d'Addictologie, CHRU Lille, F-59037 Lille, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Cottencin
mesh_terms: D019973:Alcohol-Related Disorders / Q000628:therapy*; D004636:Emergency Service, Hospital; D006801:Humans; D010342:Patient Acceptance of Health Care
keywords: Alcohol use disorder; Emergency departments; Treatment utilization