OBJECTIVE:Alcohol screening and brief intervention (SBI) has gained widespread acceptance as an effective method for reducing problem drinking in at-risk populations. This study examines the cost and cost-effectiveness of an SBI pilot program delivered in an inner-city hospital emergency department (ED) to a traditionally underserved population. METHOD: A total of 1,036 subjects were screened for problem drinking during their visit to an ED. Eligible participants (N = 294) were randomly assigned to either a brief intervention group or a control group. As the result of attrition, a final sample of 194 (90 brief intervention; 104 control) participants remained at follow-up. The intervention consisted of a brief counseling session and a health information packet. The control group received only the packet. Intervention cost data were collected and analyzed using the Drug Abuse Treatment Cost Analysis Program. Selected outcomes at the 3-month follow-up included the raw Alcohol Use Disorders Identification Test score, average weekly number of drinks and engaging in heavy drinking in the past month (>6 drinks on one occasion for men, >4 for women). Outcome differences between the intervention and control groups were estimated with both bivariate and multivariate techniques. RESULTS: The average economic cost of the brief intervention was dollars 632 per subject, of which screening (dollars 497) was the largest component. In all cases, intervention subjects had better 3-month outcomes than control subjects, but the differences were not always statistically significant. Cost-effectiveness ratios were relatively small for all three outcomes, suggesting this type of intervention has the potential to be cost-effective under full implementation. CONCLUSIONS: The preliminary results demonstrate the potential advantage of further research in this area with larger samples and a longer follow-up period.
RCT Entities:
OBJECTIVE:Alcohol screening and brief intervention (SBI) has gained widespread acceptance as an effective method for reducing problem drinking in at-risk populations. This study examines the cost and cost-effectiveness of an SBI pilot program delivered in an inner-city hospital emergency department (ED) to a traditionally underserved population. METHOD: A total of 1,036 subjects were screened for problem drinking during their visit to an ED. Eligible participants (N = 294) were randomly assigned to either a brief intervention group or a control group. As the result of attrition, a final sample of 194 (90 brief intervention; 104 control) participants remained at follow-up. The intervention consisted of a brief counseling session and a health information packet. The control group received only the packet. Intervention cost data were collected and analyzed using the Drug Abuse Treatment Cost Analysis Program. Selected outcomes at the 3-month follow-up included the raw Alcohol Use Disorders Identification Test score, average weekly number of drinks and engaging in heavy drinking in the past month (>6 drinks on one occasion for men, >4 for women). Outcome differences between the intervention and control groups were estimated with both bivariate and multivariate techniques. RESULTS: The average economic cost of the brief intervention was dollars 632 per subject, of which screening (dollars 497) was the largest component. In all cases, intervention subjects had better 3-month outcomes than control subjects, but the differences were not always statistically significant. Cost-effectiveness ratios were relatively small for all three outcomes, suggesting this type of intervention has the potential to be cost-effective under full implementation. CONCLUSIONS: The preliminary results demonstrate the potential advantage of further research in this area with larger samples and a longer follow-up period.
Authors: Shannon Gwin Mitchell; Robert P Schwartz; Arethusa S Kirk; Kristi Dusek; Marla Oros; Colleen Hosler; Jan Gryczynski; Carolina Barbosa; Laura Dunlap; David Lounsbury; Kevin E O'Grady; Barry S Brown Journal: J Subst Abuse Treat Date: 2015-06-26
Authors: R S Braithwaite; J Conigliaro; M S Roberts; S Shechter; A Schaefer; K McGinnis; M C Rodriguez; L Rabeneck; K Bryant; A C Justice Journal: AIDS Care Date: 2007-04
Authors: Maureen A Walton; Abby L Goldstein; Stephen T Chermack; Ryan J McCammon; Rebecca M Cunningham; Kristen L Barry; Frederic C Blow Journal: J Stud Alcohol Drugs Date: 2008-07 Impact factor: 2.582