Pol Bruguera1,2,3,4, Pablo Barrio1,2,3,4, Clara Oliveras2,3, Fleur Braddick1,2,3, Carolina Gavotti1,2,3, Carla Bruguera5, Hugo López-Pelayo1,2,3,4, Laia Miquel1,2,3,4, Lídia Segura5, Joan Colom5, Lluisa Ortega1,2,3,4, Eduard Vieta2,6,4, Antoni Gual1,2,3,4. 1. Addictive Behaviors Unit, Clinical Neuroscience Institute, Hospital Clínic, Barcelona, Spain. 2. Department of Psychiatry and Clinical Psychobiology, University of Barcelona, Barcelona, Spain. 3. Grup de Recerca en Addiccions Clínic, Hospital Clínic de Barcelona, IDIBAPS, Universitat de Barcelona, Red de Trastornos Adictivos (RETICS), Barcelona, Spain. 4. Bipolar Disorder Program, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, Barcelona, Spain. 5. Program on Substance Abuse, Public Health Agency, Government of Catalonia, Barcelona, Spain. 6. Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain.
Abstract
BACKGROUND: Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs have been developed, evaluated, and shown to be effective, particularly in primary care and general practice. Nevertheless, effectiveness of SBIRT in emergency departments (EDs) has not been clearly established. OBJECTIVE: We aimed to evaluate the feasibility and efficacy of an SBIRT program conducted by highly specialized professionals in the ED of a tertiary hospital. METHODS: We conducted a randomized controlled trial to study the feasibility and efficacy of an SBIRT program conducted by alcohol specialists for at-risk drinkers presenting to the ED, measured with the three-item version of the Alcohol Use Disorder Identification Test (AUDIT-C). Patients were randomized to two groups, with the control group receiving two leaflets-one regarding alcohol use and the other giving information about the study protocol. The intervention group received the same leaflets as well as a brief motivational intervention on alcohol use and, where appropriate, a referral to specialized treatment. The primary outcomes were the proportion of at-risk alcohol use measured by AUDIT-C scale and the proportion of patients attending specialized treatment at 1.5 months. RESULTS: Of 3,027 patients presenting to the ED, 2,044 (67%) were potentially eligible to participate, 247 (12%) screened positive for at-risk drinking, and 200 agreed to participate. Seventy-two percent of the participating sample were men, and the mean (±SD) age was 43 (±16.7) years. Follow-up rates were 76.5%. At 1.5 months, the intervention group showed greater reductions in alcohol consumption and fewer patients continuing with at-risk alcohol use (27.8% vs. 48.1%; p = 0.01). The SBIRT program also increased the probability of attending specialized treatment, compared to the control condition (23% vs. 9.8%, p = 0.0119) CONCLUSION: The SBIRT program in the ED was found to be feasible and effective in identifying at-risk drinkers, reducing at-risk alcohol use, and increasing treatment for alcohol problems.
RCT Entities:
BACKGROUND: Screening, Brief Intervention, and Referral to Treatment (SBIRT) programs have been developed, evaluated, and shown to be effective, particularly in primary care and general practice. Nevertheless, effectiveness of SBIRT in emergency departments (EDs) has not been clearly established. OBJECTIVE: We aimed to evaluate the feasibility and efficacy of an SBIRT program conducted by highly specialized professionals in the ED of a tertiary hospital. METHODS: We conducted a randomized controlled trial to study the feasibility and efficacy of an SBIRT program conducted by alcohol specialists for at-risk drinkers presenting to the ED, measured with the three-item version of the Alcohol Use Disorder Identification Test (AUDIT-C). Patients were randomized to two groups, with the control group receiving two leaflets-one regarding alcohol use and the other giving information about the study protocol. The intervention group received the same leaflets as well as a brief motivational intervention on alcohol use and, where appropriate, a referral to specialized treatment. The primary outcomes were the proportion of at-risk alcohol use measured by AUDIT-C scale and the proportion of patients attending specialized treatment at 1.5 months. RESULTS: Of 3,027 patients presenting to the ED, 2,044 (67%) were potentially eligible to participate, 247 (12%) screened positive for at-risk drinking, and 200 agreed to participate. Seventy-two percent of the participating sample were men, and the mean (±SD) age was 43 (±16.7) years. Follow-up rates were 76.5%. At 1.5 months, the intervention group showed greater reductions in alcohol consumption and fewer patients continuing with at-risk alcohol use (27.8% vs. 48.1%; p = 0.01). The SBIRT program also increased the probability of attending specialized treatment, compared to the control condition (23% vs. 9.8%, p = 0.0119) CONCLUSION: The SBIRT program in the ED was found to be feasible and effective in identifying at-risk drinkers, reducing at-risk alcohol use, and increasing treatment for alcohol problems.
Authors: Kei Ouchi; Naomi George; Anna C Revette; Mohammad Adrian Hasdianda; Lauren Fellion; Audrey Reust; Lynda H Powell; Rebecca Sudore; Jeremiah D Schuur; Mara A Schonberg; Edward Bernstein; James A Tulsky; Susan D Block Journal: J Palliat Med Date: 2018-11-12 Impact factor: 2.947
Authors: Kei Ouchi; Naomi George; Jeremiah D Schuur; Emily L Aaronson; Charlotta Lindvall; Edward Bernstein; Rebecca L Sudore; Mara A Schonberg; Susan D Block; James A Tulsky Journal: Ann Emerg Med Date: 2019-02-13 Impact factor: 5.721
Authors: Richard E Leiter; Miryam Yusufov; Mohammad Adrian Hasdianda; Lauren A Fellion; Audrey C Reust; Susan D Block; James A Tulsky; Kei Ouchi Journal: J Pain Symptom Manage Date: 2018-09-14 Impact factor: 3.612
Authors: Thidathit Prachanukool; Susan D Block; Donna Berry; Rachel S Lee; Sarah Rossmassler; Mohammad A Hasdianda; Wei Wang; Rebecca Sudore; Mara A Schonberg; James A Tulsky; Kei Ouchi Journal: Trials Date: 2022-10-09 Impact factor: 2.728
Authors: Mohammad Adrian Hasdianda; Tamryn F Gray; Josephine Lo Bello; Brittany Ballaron; Natasha A Egorova; Donna L Berry; Kei Ouchi Journal: Palliat Med Rep Date: 2021-03-12