title: Evaluation of screening and brief intervention for hazardous alcohol use integrated into clinical practice in an inner-city Emergency Department.
abstract: BACKGROUND
  In small studies, Screening, Brief Intervention and Referral to Treatment (SBIRT) in Emergency Departments (EDs) is effective in reducing hazardous alcohol use.
  
  
  OBJECTIVE
  To examine the effectiveness of SBIRT at an inner-city ED in routine clinical practice.
  
  
  METHODS
  Of the 41 900 consecutive ED patients aged 18 years and older, 22 537 (53.8%) were screened using the Alcohol Use Disorders Identification Test (AUDIT-C). Patients with positive AUDIT-C scores (men≥5 and women≥4) received educational leaflets. Brief interventions were performed by ED personnel trained in motivational interviewing. At 3 months, patients were contacted by telephone and recent drinking pattern was assessed.
  
  
  RESULTS
  Out of 22 537 patients, 2209 (9.8%) had an elevated AUDIT-C score. Male sex, alcohol-related reason for ED visit, alcohol or other intoxication at ED visit, head injury, stomach or intestinal bleeding and wounds were significant predictors of hazardous alcohol use in both univariate and multivariate analysis (all P<0.001). Out of 2209 patients, 894 (40.5%) AUDIT-C-positive patients received an intervention: of these 894 patients, 70% received educational material and 30% received motivational intervention and educational material. In the subset of patients available for follow-up, 34.9% either reduced or stopped alcohol use.
  
  
  CONCLUSIONS
  Our study shows that in a large inner-city ED, SBIRT can be implemented in daily care. Screening uncovered large numbers of patients with hazardous alcohol use and identified several risk factors. Moreover, screening and intervention appeared to be effective in reducing alcohol intake.
authors.affiliation: aDepartment of Emergency Medicine, Medical Centre Haaglanden, The Hague bDelta, Rotterdam, The Netherlands.
authors.forename: Merel
authors.initials: M
authors.lastname: van Loon
authors.forename: Angelique C P
authors.initials: ACP
authors.lastname: van Gaalen
authors.forename: M Christien
authors.initials: MC
authors.lastname: van der Linden
authors.forename: Carla
authors.initials: C
authors.lastname: Hagestein-De Bruijn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D004636:Emergency Service, Hospital; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods; D014505:Urban Population; D055815:Young Adult