Effectiveness of Alcohol Brief Intervention in a General Hospital: A Randomized Controlled Trial

Abstract

ABSTRACT. Objective: The purpose of this study was to examine the effectiveness of an alcohol brief intervention (ABI) on alcohol consumption in hazardous or harmful drinkers compared with screening alone within a general hospital setting. Method: Following screening, 124 hazardous or harmful drinkers (103 men, ages 18-80 years, score of 3-12 on the Fast Alcohol Screening Test [FAST]) admitted to medical and orthopedic wards during the 13-month recruitment period were randomized to receive an ABI or control. The intervention group received an ABI where they were supported to set their own personalized alcohol reduction goals, and both groups received a health information leaflet. Retrospective alcohol consumption for 7 days was reported for the week, before hospital admission and 6 months after it. Results: Demographics and clinical characteristics at baseline showed no statistical differences between the two groups on all variables except FAST score, which was higher in the intervention group (p ≤ .05). A reduction of 85 grams of alcohol per week (95% CI [162.46, 7.54]) was observed between groups in favor of the intervention group based on changes from baseline. However, there was no significant difference between groups for absolute grams of alcohol per week at 6 months. A significant mean difference in favor of the intervention group (U = 1,537, p = .043) was observed for weekly heavy drinking episodes. Conclusions: Our results suggest screening with delivery of ABI for harmful/hazardous drinkers in a general hospital is beneficial in reducing alcohol consumption compared with screening alone. (J. Stud. Alcohol Drugs, 76, 838-844, 2015)

Factors associated with alcohol reduction in harmful and hazardous drinkers following alcohol brief intervention in Scotland: a qualitative enquiry

“…Together, the narrative accounts obtained within this study highlight the challenges for a subgroup of participants who reduced or abstained from alcohol after receiving an ABI, and explain the process of change in greater depth than the quantitative findings alone, which are presented separately [3]. The qualitative findings add depth and breadth of knowledge, focusing not only on whether the intervention worked, but adding insight into the process of change and maintenance as well as barriers and facilitators for those who reduced or abstained from alcohol.…”

“…Those with both alcohol related and non-alcohol related diagnosis were included. All participants were in the intervention arm of a randomised controlled trial comparing ABI with usual hospital care ( n  = 124, 63 in intervention group and 61 in control group reported in detail elsewhere) [3]. The sample comprised one of convenience, whereby blinding was broken for 12 participants from the intervention group.…”

“…World-wide alcohol consumption is a causal factor in more than 200 disease and injury conditions including mental and behavioural disorders, liver cirrhosis and some cancers [2]. As alcohol consumption levels and associated harms have increased, so too has the interest in alcohol brief intervention [3]. Alcohol Brief Intervention (ABI) consists of a motivational counselling approach involving a time limited, one to one intervention.…”

“…Evidence from two systematic reviews suggests that ABI can support individuals in reducing their alcohol consumption [4, 5]. Within emergency and general hospital care, staff frequently encounter individuals who misuse alcohol and ABI is often delivered within these settings [3]. Whilst there is growing evidence on the impact of ABIs, the views of recipients on how they work and which components are likely to enhance success are largely unknown.…”

Spreading alcohol brief interventions from health care to non-health care settings: Is it justified?

“…It is often concluded from systematic reviews and metaanalyses that evidence in favour of the effectiveness of ABI is strongest in PHC (O'Donnell et al, 2013) but is inconsistent or limited in other medical settings, even those where enthusiasm for its potential effectiveness is perhaps strongest, like Accident and Emergency Departments (D'Onofrio & Degutis, 2002;Havard, Shakeshaft, & Sanson-Fisher, 2008) and general hospital wards (McQueen, Howe, Ballinger, & Godwin, 2015). Although implementation in these two major settings for ABI is arguably justified as evidence-based, this is not on the basis of an unequivocal or ''robust'' evidence-base.…”