Screening, brief intervention, and referral to treatment for adolescent alcohol use in Canadian pediatric emergency departments: a national survey of pediatric emergency physicians

Abstract

CLINICIAN'S CAPSULE What is known about the topic? Emergency department (ED) visits for adolescent alcohol-related concerns offer the opportunity for early intervention; however, the underlying alcohol problem generally remains unaddressed. What did this study ask? What are ED physicians' perceptions regarding adolescent alcohol use and ED-based intervention? What are their current intervention practices? What did this study find? While the majority of ED physicians feel the responsibility to address problematic adolescent alcohol use, interventional practices are unstandardized and lacking. Why does this study matter to clinicians? This study identifies the resources needed by ED physicians to deliver appropriate adolescent alcohol-related care.

Systematic Review of Clinician‐Reported Barriers to Provision of Brief Advice for Alcohol Intake in Hospital Inpatient and Emergency Settings

“…Self-completed questionnaire on practices, self-efficacy in alcohol counseling, and knowledge on health impacts of excessive alcohol consumption. Quantitative study (Bernstein et al, 2007;Broyles et al, 2012;Cunningham et al, 2010;Danielsson et al, 1999;Garnett et al, 2016;Gentilello et al, 2005;Graham et al, 2000;Griffiths et al, 2007;Hellum et al, 2016;Indig et al, 2009;Jun et al, 2019;Lee et al, 2015;Staton et al, 2018;Tsai, 2009;Weiland et al, 2008) 15 (60%) High confidence 15 studies with moderate methodological limitations. Data from 6 countries across 5 continents, predominantly in North America.…”

“…Data from 6 countries across 5 continents, predominantly in North America. No or minor concerns about coherence and adequacy Lack of skills (Broyles et al, 2012;Griffiths et al, 2007;Indig et al, 2009;Jun et al, 2019;Weiland et al, 2008) 5 (20%) Moderate confidence…”

“…Thin data from 2 countries. This barrier is seldom reported because it may be a consequence of other barriers (i.e., lack of time and overwhelming workload) Opportunity Lack of time (Anderson et al, 2001;Bernstein et al, 2007;Broyles et al, 2012;Cunningham et al, 2010;Danielsson et al, 1999;D esy and Perhats, 2008;Falc on et al, 2018;Garnett et al, 2016;Graham et al, 2000;Grønkjaer et al, 2017;Groves et al, 2010;Hellumet al, 2016;Indig et al, 2009;Jun et al, 2019;Lee et al, 2015;Staton et al, 2018;Weiland et al, 2008;Whitty et al, 2016;Yokell et al, 2014) 19 76%High confidence 19 studies with moderate methodological limitations. Data from 8 countries across 4 continents, predominantly in North America.…”

“…Lack of resources (e.g., referral resources, financial resources, treatment resources, screening devices, inadequate follow-up) (Anderson et al, 2001;Bernstein et al, 2007;Cunningham et al, 2010;Danielsson et al, 1999;D esy and Perhats, 2008;Falc on et al, 2018;Graham et al, 2000;Indig et al, 2009;Jun et al, 2019;Lee et al, 2015;Staton et al, 2018;Whitty et al, 2016;Yokell et al, 2014) 13 (52%) High confidence 13 studies with minor methodological limitations. Data from 6 countries across 5 continents, predominantly in North America.…”

“…Data from 4 countries across 4 continents, predominantly in Australia. No or minor concerns about coherence and adequacy Role uncertainty (Anderson et al, 2001;Broyles et al, 2012;Danielsson et al, 1999;D esy and Perhats, 2008;Garnett et al, 2016;Indig et al, 2009;Jun et al, 2019;Yokell et al, 2014) 8 (32%) High confidence 8 studies with minor methodological limitations. Data from 4 countries across 3 continents, predominantly in North America.…”