title: Review article: Effectiveness of ultra-brief interventions in the emergency department to reduce alcohol consumption: A systematic review.
abstract: To assess the effectiveness of ultra-brief interventions (ultra-BI) or technology-involved preventive measures in the ED to reduce alcohol harm and risky drinking. Medline, Embase, PsycINFO, CINAHL and EBM reviews were searched for articles published between 1996 and 2015. Randomised controlled trials and quasi-randomised trials, which compared an ultra-BI with screening, standard care or minimal intervention for adults and adolescents at risk for alcohol-related harm presenting to an ED, were included. Outcomes of interest were frequency of alcohol consumption, quantity of alcohol consumed, binge drinking and ED representation. Thirteen studies (nine single centre and four multicentre) were included. Six studies showed a significant reduction in the quantity consumed with intermediate effect size at 3 months (d = -0.40) and small effect size at 12 months (d = -0.15). Two studies showed a significant reduction in binge drinking with small effect size at 3 months (d = -0.12) and 12 months (d = -0.09). No studies showed an effect on frequency of alcohol consumption or ED representation. Heterogeneity in study design, definition of risky, harmful or hazardous alcohol use, intervention types, outcomes, outcome timeframes and outcome measures prevented the performance of quantitative meta-analysis. Despite its limited effectiveness in reducing alcohol use in the short-term, with the large number of people attending EDs with risky drinking, the use of an effective ultra-BI would have the potential to have a measurable population effect.
authors.affiliation: School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.
authors.forename: Rosemary A
authors.identifier: http://orcid.org/0000-0002-7657-2529
authors.initials: RA
authors.lastname: McGinnes
authors.affiliation: Emergency Department, St Vincent's Hospital, Melbourne, Victoria, Australia.
authors.forename: Jennie E
authors.initials: JE
authors.lastname: Hutton
authors.affiliation: Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia.|Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Tracey J
authors.initials: TJ
authors.lastname: Weiland
authors.affiliation: Emergency Medicine, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Daniel M
authors.identifier: http://orcid.org/0000-0001-9414-6905
authors.initials: DM
authors.lastname: Fatovich
authors.affiliation: School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.|Monash Medical Centre Emergency Department, Monash Health, Melbourne, Victoria, Australia.
authors.forename: Diana
authors.initials: D
authors.lastname: Egerton-Warburton
mesh_terms: D000428:Alcohol Drinking / Q000517:prevention & control*; D019973:Alcohol-Related Disorders / Q000517:prevention & control; D003376:Counseling / Q000379:methods*; D004636:Emergency Service, Hospital; D006801:Humans; D017063:Outcome Assessment, Health Care
keywords: alcohol harm; brief intervention; emergency department; systematic review