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Acceptability of Emergency Department‐based Screening and Brief Intervention for Alcohol Problems
Author(s) -
Hungerford Daniel W.,
Pollock Daniel A.,
Todd Knox H.
Publication year - 2000
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2000.tb00496.x
Subject(s) - medicine , alcohol use disorders identification test , emergency department , referral , brief intervention , intervention (counseling) , alcohol , audit , alcohol dependence , alcohol abuse , emergency medicine , family medicine , injury prevention , psychiatry , poison control , biochemistry , chemistry , management , economics
.Objectives: To adapt screening and brief intervention for alcohol problems (SBI) to a high‐volume emergency department (ED) setting and evaluate its acceptability to patients. Methods: Patients at a large public‐hospital ED were screened with the Alcohol Use Disorders Identification Test (AUDIT). Screen‐positive drinkers (AUDIT score ≥ 6) were provided brief, on‐site counseling and referral as needed. Three months later, project staff blinded to baseline measures reassessed alcohol intake, alcohol‐related harm, alcohol dependence symptoms, and readiness to change. Results: Of 1,034 patients approached, 78.3% (810) consented to participate (95% CI = 75.5% to 81.2%), and 21.2% (172) screened positive (95% CI = 18.4% to 24.0%). Of 88 patients with complete intervention data, 94.3% (83) accepted an intervention (95% CI = 89.5% to 99.2%), with acceptance rates ranging from 93% to 100% across four alcohol‐problem‐severity levels (p = 0.7). A majority (59.0%) set goals to decrease or stop drinking (95% CI = 48.4% to 69.6%). The group recontacted ( n = 23) experienced statistically significant decreases in alcohol intake, alcohol‐related harm, and dependence symptoms, with measures decreasing for 68%, 52%, and 61% of the patients. Readiness to change also showed statistically significant improvement, with scores increasing for 43% of the patients. Moreover, two‐thirds of the patients (15/23) reported at follow‐up that SBI was a helpful part of their ED visit. Conclusions: High rates of consent and acceptance of counseling for alcohol problems by patients across a wide range of problem severity indicate that this protocol was acceptable to at‐risk patients in a public‐hospital ED. Improvements in alcohol‐related outcome measures at follow‐up were strong enough to warrant controlled studies of intervention efficacy.