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‘Inconclusive’ was the verdict of a review which aimed to assess the effectiveness of brief alcohol interventions among patients aged 11 to 21 attending for emergency care in the USA. Most promising targets seem to have been the more heavy or irresponsibly drinking among patients who were young adults rather than adolescents.
Review of studies of interventions for heavy drinkers identified among general hospital inpatients concluded that multi-session brief interventions could reduce drinking. “Could” is an important qualifier: yet to be pinned down is why though sometimes they work, brief interventions often fail to produce significant effects.
REVIEW 2011 HTM file
Brief interventions for heavy alcohol users admitted to general hospital wards
Many with alcohol-related disorders, risky drinking hospital inpatients with time to reflect on their problems ought to be prime candidates for brief advice. This updated synthesis of studies found some significant impacts but these were inconsistent, perhaps because merely being identified as a heavy drinker has an impact on its own.
US trauma centres dealing with serious and often alcohol-related injuries ought to offer an environment conducive to brief alcohol interventions, but this first multi-site trial found motivational counselling more effective than minimal advice only when combined with a follow-up ‘booster’ phone call.
Analysis of the only four randomised trials of brief alcohol interventions among 18–24-years-olds seen at emergency departments after getting drunk tentatively suggested that booster sessions or later advice are needed to reduce drinking.
Based on research findings, a practical US government guide for trauma centres dealing with serious injuries on how to plan, implement and monitor a programme to identify risky drinking among their patients and to offer appropriate advice and referral.
A computer-delivered brief intervention plus booster mailings increased the alcohol abstinence rate and improved pregnancy outcomes among risky drinking pregnant women recruited at a US antenatal clinic, though in this small pilot trial the results were not statistically significant.
REVIEW 2015 HTM file
A comparison of the efficacy of brief interventions to reduce hazardous and harmful alcohol consumption between European and non-European countries: a systematic review and meta-analysis of randomized controlled trials
Amalgamation of results from relevant studies finds that in high-income nations brief alcohol advice to emergency or primary care patients remains effective whether trials take place in European or non-European drinking cultures and health service contexts. Impacts were however small and may not be duplicated in routine practice.
DOCUMENT 2015 HTM file
Online flowcharts from the UK National Institute for Health and Clinical Excellence guide planners and practitioners dealing with alcohol use disorders through choices of strategies and interventions on prevention, brief interventions, alcohol treatment, and treatment of associated medical conditions.
Simulation exercise estimates that had either the main anti-relapse medications or brief interventions on hospital wards reached 40% of the heaviest and dependent drinkers, in 2004 they would have prevented nearly 12,000 deaths across the European Union.
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