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STUDY 2003 PDF file 172Kb
Injury rate cut in heavy drinking accident and emergency patients
One of the few studies to have tried alcohol interventions in the emergency department rather than after admission was also the first to find a significant reduction in later injuries, but only if the initial approach had been reinforced with a booster.
Just a few minutes with specially hired screening and intervention staff can make a difference to emergency patients' drinking, but in the real world the hospital's own staff will usually do this work. A US study tested this real-world scenario and still found (modest) drinking reductions.
STUDY 2006 PDF file 199Kb
A&E units save health service resources by addressing drinking
This US study estimated that each $ spent screening for and offering advice to heavy drinking emergency patients would save nearly $4 in health care costs due to reduced hospital re-attendance. A British trial suggests similar savings might be found in the UK.
Set in Sweden, the first study among psychiatric outpatients to test brief alcohol interventions against screening alone found worthwhile extra drinking reductions after brief motivational advice. Use of a telephone-based intervention was another innovation.
In the study of Swiss army conscripts, reflective listening emerged as possibly the key active ingredient in a brief alcohol intervention based on motivational interviewing.
At a US emergency department, a brief conversation about the pros and cons of their risky drinking and offers of support for any efforts to reduce harm curbed drinking among alcohol-dependent patients; non-dependent patients tended to do better with assessment and usual care only.
At a US emergency department, a brief conversation about the pros and cons of their drinking and offers of support for any efforts to reduce harm led (compared to assessment and usual care) to extra reductions in the drinking of injured Hispanic patients but not white or black patients.
At a US emergency department, a brief conversation about the pros and cons of their risky drinking and offers of support for any efforts to reduce harm led to extra reductions in the drinking of Hispanic patients which were greatest when they were matched to a Hispanic and Spanish-speaking counsellor.
A few minutes with specially hired interventionists can curb the intake of heavy-drinking emergency patients, but in routine practice hospital staff will usually have to do this work. A US study tested this real-world scenario and found the modest drinking reductions were short-lived.
In Madrid, unusually a primary care brief alcohol intervention targeted heavy episodic or 'binge' drinking. The result was drinking reductions which probably saved lives due to less drunkenness and less drinking overall – and both screening and intervention were done by the doctors themselves, not specialist staff.
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