Brief Interventions for at-Risk Drinking: Patient Outcomes and Cost-Effectiveness in Managed Care Organizations

Babor, Thomas F.; Higgins-Biddle, John C; Dauser, Deborah; Burleson, Joseph A.; Zarkin, Gary A.; Bray, Jeremy

doi:10.1093/alcalc/agl078

Cited by 87 publications

(74 citation statements)

References 14 publications

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“…Results from this meta-analysis indicate that more primary studies are needed to directly compare different single-session interventions for heavy drinking college students-especially to untangle the effects of feedback and MET/MI modalities-and with longer follow-up. Given the modest average effect size, researchers should also continue developing more potent interventions by refining elements that appear most effective and/or developing new approaches (e.g., Babor et al, 2006).…”

Section: Limitations and Future Directionsmentioning

confidence: 99%

Single-Session Alcohol Interventions for Heavy Drinking College Students: A Systematic Review and Meta-Analysis

Samson

Tanner‐Smith

2015

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: The purpose of this study was to conduct a meta-analysis summarizing the effectiveness of brief, single-session interventions to reduce alcohol use among heavy drinking college students. Method: A comprehensive literature search identified 73 studies comparing the effects of single-session brief alcohol intervention with treatment-as-usual or no-treatment control conditions on alcohol use among heavy drinking college students. Random-effects meta-analyses with robust variance estimates were used to synthesize 662 effect sizes, estimating the average overall effect of the interventions and the variability in effects across a range of moderators. Results: An overall mean effect size of g\ = 0.18, 95% CI [0.12, 0.24] indicated that, on average, single-session brief alcohol interventions significantly reduced alcohol use among heavy drinking college students relative to comparison conditions. There was minimal variability in effects associated with study method and quality, general study characteristics, participant demographics, or outcome measure type. However, studies using motivational enhancement therapy/motivational interviewing (MET/MI) modalities reported larger effects than those using psychoeducational therapy (PET) interventions. Further investigation revealed that studies using MET/ MI and feedback-only interventions, but not those using cognitive-behavioral therapy or PET modalities, reported average effect sizes that differed significantly from zero. There was also evidence that long-term effects were weaker than short-term effects. Conclusions: Single-session brief alcohol interventions show modest effects for reducing alcohol consumption among heavy drinking college students and may be particularly effective when they incorporate MET/MI principles. More research is needed to directly compare intervention modalities, to develop more potent interventions, and to explore the persistence of long-term effects. (J. Stud. Alcohol Drugs, 76, 530-543, 2015)

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Section: Limitations and Future Directionsmentioning

confidence: 99%

Single-Session Alcohol Interventions for Heavy Drinking College Students: A Systematic Review and Meta-Analysis

Samson

Tanner‐Smith

2015

J. Stud. Alcohol Drugs

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“…Alcohol SBI has been shown to be effective at reducing hazardous drinking in numerous effi cacy studies (e.g., Babor and Higgins-Biddle, 2001;Babor et al, 2006Babor et al, , 2007Ballesteros et al, 2004;Bien et al, 1993;D'Onofrio and Degutis, 2002;Moyer et al, 2002;Wallace et al, 1988;Whitlock et al, 2004;WHO Brief Intervention Study Group, 1996;Wilk et al, 1997). The widespread dissemination of SBI and SBIRT has received considerable policy support in the United States.…”

Section: S Creening and Brief Intervention (Sbi) Formentioning

confidence: 99%

Costs of Alcohol Screening and Brief Intervention in Medical Settings: A Review of the Literature

Bray

Zarkin²,

Hinde³

et al. 2012

J. Stud. Alcohol Drugs

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ABSTRACT. Objective: This article summarizes the literature on the implementation costs of alcohol screening and brief intervention (SBI) in medical settings. Method: Electronic databases were searched using SBI-and cost-related terms. Methodological approaches and cost estimates were abstracted from each study and categorized based on the cost methodology. Costs were updated to 2009 U.S. dollars. To determine a summary cost measure, we excluded outliers and computed the median of the remaining cost estimates. Results: Seventeen studies with cost estimates were identifi ed for further study. Costs ranged from $0.51 to $601.50 per screen and from $3.41 to $243.01 per brief intervention (BI). Cost estimates were lower when an activity-based cost methodology was used, in primary care settings, and when the provider was not a doctor. The median summary cost of a screen is approximately $4, and the median summary cost of a BI is approximately $48. Conclusions: Screening cost estimates had more variation than BI cost estimates. Provider type and service delivery time drive the cost variation. Interpretation of cost differences was limited by insuffi cient reporting of the cost methodology. Cost estimates presented here are similar in size to the Healthcare Common Procedure Coding System and Current Procedural Terminology reimbursement amounts, suggesting that insurance-based service reimbursement may be suffi cient to sustain alcohol SBI in practice. (J. Stud. Alcohol Drugs, 73, 911-919, 2012)

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“…Evidence supporting alcohol brief interventions in adult primary care settings has largely been derived from efficacy trials [11][12][13][14], and important questions remain about how SBI can be implemented within regular medical care and the 'dose' of intervention needed for it to be effective. Alcohol SBI research is now moving toward gathering more practice-based evidence, with studies integrating SBI into regular care processes without reliance on research staff.…”

Section: Screening and Brief Intervention In Outpatient Settingsmentioning

confidence: 99%

Update in Addiction Medicine for the Generalist

et al. 2007

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Increasingly, patients with unhealthy alcohol and other drug use are being seen in primary care and other non-specialty addiction settings. Primary care providers are well positioned to screen, assess, and treat patients with alcohol and other drug use because this use, and substance use disorders, may contribute to a host of medical and mental health harms. We sought to identify and examine important recent advances in addiction medicine in the medical literature that have implications for the care of patients in primary care or other generalist settings. To accomplish this aim, we selected articles in the field of addiction medicine, critically appraised and summarized the manuscripts, and highlighted their implications for generalist practice. During an initial review, we identified articles through an electronic Medline search (limited to human studies and in English) using search terms for alcohol and other drugs of abuse published from January 2010 to January 2012. After this initial review, we searched for other literature in web-based or journal resources for potential articles of interest. From the list of articles identified in these initial reviews, each of the six authors independently selected articles for more intensive review and identified the ones they found to have a potential impact on generalist practice. The identified articles were then ranked by the number of authors who selected each article. Through a consensus process over 4 meetings, the authors reached agreement on the articles with implications for practice for generalist clinicians that warranted inclusion for discussion. The authors then grouped the articles into five categories: 1) screening and brief interventions in outpatient settings, 2) identification and management of substance use among inpatients, 3) medical complications of substance use, 4) use of pharmacotherapy for addiction treatment in primary care and its complications, and 5) integration of addiction treatment and medical care. The authors discuss each selected articles' merits, limitations, conclusions, and implication to advancing addiction screening, assessment, and treatment of addiction in generalist physician practice environments.

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Brief Interventions for at-Risk Drinking: Patient Outcomes and Cost-Effectiveness in Managed Care Organizations

Cited by 87 publications

References 14 publications

Single-Session Alcohol Interventions for Heavy Drinking College Students: A Systematic Review and Meta-Analysis

Single-Session Alcohol Interventions for Heavy Drinking College Students: A Systematic Review and Meta-Analysis

Costs of Alcohol Screening and Brief Intervention in Medical Settings: A Review of the Literature

Update in Addiction Medicine for the Generalist

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