Variance in the Efficacy of Brief Interventions to Reduce Hazardous and Harmful Alcohol Consumption Between Injury and Noninjury Patients in Emergency Departments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Elzerbi, Catherine; Donoghue, Kim; Boniface, Sadie; Drummond, Colin

doi:10.1016/j.annemergmed.2017.05.004

Cited by 17 publications

(17 citation statements)

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“…Although specific therapeutic techniques vary, many of these interventions seek to increase motivation by providing individuals normative feedback about individualized risk of developing AUD, inquiring about the desire to change their drinking, and working collaboratively to explore and develop behavior change options (3). Meta-analyses have identified small yet robust effects of brief interventions on alcohol consumption that can be flexibly administered in multiple settings, including hospital emergency departments, primary care, and via digital/tele-therapy (2–4). Brief interventions have also been shown to sustain drinking reductions at 12-month follow-up (4).…”

Section: Introductionmentioning

confidence: 99%

“…Meta-analyses have identified small yet robust effects of brief interventions on alcohol consumption that can be flexibly administered in multiple settings, including hospital emergency departments, primary care, and via digital/tele-therapy (2–4). Brief interventions have also been shown to sustain drinking reductions at 12-month follow-up (4).…”

Section: Introductionmentioning

confidence: 99%

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An Examination of Motivation to Change and Neural Alcohol Cue Reactivity Following a Brief Intervention

et al. 2019

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Background: Brief interventions represent a promising psychological intervention targeting individuals with heavy alcohol use. Motivation to change represents an individual’s openness to engage in a behavior change strategy and is thought to be a crucial component of brief interventions. Neuroimaging techniques provide a translational tool to investigate the neurobiological mechanisms underlying potential mediators of treatment response, including motivation to change. Therefore, this study aimed to examine the effect of a brief intervention on motivation to change drinking behavior and neural alcohol taste cue reactivity. Methods: Non–treatment-seeking heavy drinkers were randomized to receive a brief drinking intervention (n = 22) or an attention-matched control (n = 24). Three indices of motivation to change were assessed at baseline and after the intervention or control session: importance, confidence, and readiness. Immediately following the intervention or control session, participants also underwent an functional magnetic resonance imaging (fMRI) during which they completed an alcohol taste cues paradigm. Results: There was a significant effect of the brief intervention on increasing ratings of importance of changing drinking behavior, but not on ratings of confidence or readiness to change. Ratings of importance after the intervention or control session were associated with neural alcohol taste cue reactivity, but notably, this effect was only significant for participants who received the intervention. Individuals in the intervention condition showed a positive association between ratings of importance and activation in the precuneus, posterior cingulate, and insula. Conclusions: The brief drinking intervention was successful at improving one dimension of motivation to change among non–treatment-seeking heavy drinkers. The brief intervention moderated the relationship between ratings of importance and brain activation in circuitry associated with interoceptive awareness and self-reflection. Together, findings represent an initial step toward understanding the neurobiological mechanisms through which a brief intervention may improve motivation to change.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An Examination of Motivation to Change and Neural Alcohol Cue Reactivity Following a Brief Intervention

et al. 2019

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“…Other authors also suggest that the application of screening instruments with feedback can be effective for reducing alcohol intake, including in emergency services (5,(8)(9)24,28) . Although this study has found the impact of BI paired with art therapy practice, and considering that this study was conducted as an academic project supported by a funding agency, a meta-analysis study done with randomized clinical trials (28) confirms the need for researchers to continue the project but focusing on permanent education in health, since the cited study found that BI contributes to the adhesion to treatment. With regard to alcohol users, the positive results of the interventions occur quickly but are only guaranteed when continuous and long-term actions are implemented.…”

Section: Discussionmentioning

confidence: 99%

Impact of brief intervention and art therapy for alcohol users

et al. 2019

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Objective: To identify the impact of brief intervention paired with art therapy in patients who use alcohol. Method: This study presents intra-group design, with 11 alcoholics in the city of Tamarana-PR, Brazil, between 2015 and 2016. A test to identify the alcohol consumption level was used at the beginning/end of the actions. Cohen’s effect size and paired t-test were used to identify the impact of the actions on the reduction of alcohol intake. Results: Six participants ceased alcohol consumption, four showed high level of consumption and one presented average consumption. The paired t-test result suggested statistically significant difference between the initial and final scores, as well as 0.76 effect size. Conclusion: The brief intervention associated with the art therapy resulted in significant impact in reducing alcohol consumption. Investing in the continuous training of primary health care professionals is crucial to consolidate the improvements achieved.

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“…With this variability in mind, certain treatments may be better targeted for individuals who are higher or lower on the AUD severity spectrum [ 1 ]. Brief intervention (BI) is supported as an effective behavioral strategy designed to address risky drinking in individuals with heavy alcohol use who have yet to transition to a more severe AUD profile [ 3 ]. BI typically consists of a single session, ranging from 5 to 60 min, and is designed to increase one’s motivation for behavior change (i.e., drinking reductions) by encouraging self-awareness and monitoring of high-risk drinking situations and alcohol-related consequences.…”

Section: Introductionmentioning

confidence: 99%

Preliminary study of alcohol problem severity and response to brief intervention

Meredith

Grodin

Karno

et al. 2021

Addict Sci Clin Pract

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Background Findings have been mixed as to whether brief intervention (BI) is appropriate and effective for individuals with more severe alcohol use problems. Motivation to change drinking has been supported as a mechanism of behavior change for BI. This exploratory study examined aspects of motivation as mechanisms of clinical response to BI and alcohol problem severity as a moderator of treatment effects. Methods Non-treatment-seeking heavy drinkers (average age = 35 years; 57% male) were randomized to receive BI (n = 27) or attention-matched control (n = 24). Three indices of motivation to change were assessed at baseline and post-intervention: importance, confidence, and readiness. Moderated mediation analyses were implemented with treatment condition as the focal predictor, changes in motivation as mediator, 1-month follow-up drinks per day as the outcome, and an alcohol severity factor as second-stage moderator. Results Analysis of importance displayed a significant effect of intervention condition on importance (p < 0.003) and yielded a significant index of moderated mediation (CI − 0.79, − 0.02), indicating that the conditional indirect effect of treatment condition on drinking through importance was stronger for those with higher alcohol severity. For all motivation indices, alcohol severity moderated the effect of post-intervention motivation levels on drinking (p’s < 0.05). The direct effect of treatment condition on drinking was not significant in any model. Conclusions Findings highlight the relevance of considering one’s degree of alcohol problem severity in BI and alcohol screening efforts among non-treatment seeking heavy drinkers. These nuanced effects elucidate both potential mechanisms and moderators of BI response. Trial registration Clinicaltrials.gov: NCT04710095. Registered January 14, 2021—retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT04710095.

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Variance in the Efficacy of Brief Interventions to Reduce Hazardous and Harmful Alcohol Consumption Between Injury and Noninjury Patients in Emergency Departments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cited by 17 publications

References 68 publications

An Examination of Motivation to Change and Neural Alcohol Cue Reactivity Following a Brief Intervention

An Examination of Motivation to Change and Neural Alcohol Cue Reactivity Following a Brief Intervention

Impact of brief intervention and art therapy for alcohol users

Preliminary study of alcohol problem severity and response to brief intervention

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