Anne C Fernandez1, Rebecca Waller2, Maureen A Walton3, Erin E Bonar3, Rosalinda V Ignacio4, Stephen T Chermack5, Rebecca M Cunningham6, Brenda M Booth7, Mark A Ilgen8, Kristen L Barry9, Frederic C Blow4. 1. Michigan Medicine, Addiction Center, Department of Psychiatry, Ann Arbor, MI, 48109, USA. Electronic address: acfernan@med.umich.edu. 2. University of Pennsylvania, Department of Psychology, Philadelphia, PA 19104, USA. 3. Michigan Medicine, Addiction Center, Department of Psychiatry, Ann Arbor, MI, 48109, USA; Michigan Medicine, Injury Prevention Center, Ann Arbor, MI, 48109, USA. 4. Michigan Medicine, Addiction Center, Department of Psychiatry, Ann Arbor, MI, 48109, USA; Veterans Affairs Ann Arbor Healthcare System, Center for Clinical Management Research, Ann Arbor, MI, 48109, USA. 5. Michigan Medicine, Addiction Center, Department of Psychiatry, Ann Arbor, MI, 48109, USA; Veterans Affairs Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, MI, 48105, USA. 6. Michigan Medicine, Injury Prevention Center, Ann Arbor, MI, 48109, USA; Michigan Medicine, Department of Emergency Medicine, Ann Arbor, MI, 48109, United States; Hurley Hospital, Flint, MI, 48503, USA; University of Michigan, School of Public Health, Ann Arbor, MI, 48109, USA. 7. University of Arkansas for Medical Sciences, Department of Psychiatry, Little Rock, AR, 72205, USA. 8. Michigan Medicine, Addiction Center, Department of Psychiatry, Ann Arbor, MI, 48109, USA; Veterans Affairs Ann Arbor Healthcare System, Center for Clinical Management Research, Ann Arbor, MI, 48109, USA; Veterans Affairs Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, MI, 48105, USA. 9. Michigan Medicine, Addiction Center, Department of Psychiatry, Ann Arbor, MI, 48109, USA.
Abstract
BACKGROUND: The primary aim of this study was to examine the efficacy of two motivational interviewing-based alcohol brief interventions (BIs) among adults presenting to an emergency department (ED). The secondary aim was to evaluate moderators of intervention effects. METHODS:Participants were 750 ED patients reporting recent alcohol misuse. Participants were randomly assigned to: 1) computer-delivered BI (Computer BI), 2) therapist-delivered BI with computer guidance (Therapist BI-CG), or 3) control. The BIs focused on reduction of alcohol use and risk behaviors. The outcome measure was trajectories of alcohol consumption (measured by the AUDIT-C) across baseline, 3-, 6- and 12-month follow-up assessments, analyzed using latent growth curve modeling. Moderation of intervention effect by gender, age, and baseline alcohol use disorder severity was examined. RESULTS: Across the full sample (40% males, mean age = 35.8, SD = 12.3), there was an overall reduction in alcohol consumption across 12 months. The main effects of the Therapist and Computer BI were not significant relative to control. Moderation analysis revealed that the impact of Therapist BI-CG, relative to control, was greater on reductions in alcohol consumption in participants with moderate to severe symptoms of alcohol use disorder compared to those with mild symptoms. The effect of the Computer BI on alcohol use, relative to control, was greater among younger participants compared to older participants. CONCLUSIONS: While no overall effect was shown, ED-based Therapist BI-CG with computer guidance may be effective among patients with moderate-severe drinking patterns, whereas Computer BIs may be more effective for younger participants.
RCT Entities:
BACKGROUND: The primary aim of this study was to examine the efficacy of two motivational interviewing-based alcohol brief interventions (BIs) among adults presenting to an emergency department (ED). The secondary aim was to evaluate moderators of intervention effects. METHODS:Participants were 750 ED patients reporting recent alcohol misuse. Participants were randomly assigned to: 1) computer-delivered BI (Computer BI), 2) therapist-delivered BI with computer guidance (Therapist BI-CG), or 3) control. The BIs focused on reduction of alcohol use and risk behaviors. The outcome measure was trajectories of alcohol consumption (measured by the AUDIT-C) across baseline, 3-, 6- and 12-month follow-up assessments, analyzed using latent growth curve modeling. Moderation of intervention effect by gender, age, and baseline alcohol use disorder severity was examined. RESULTS: Across the full sample (40% males, mean age = 35.8, SD = 12.3), there was an overall reduction in alcohol consumption across 12 months. The main effects of the Therapist and Computer BI were not significant relative to control. Moderation analysis revealed that the impact of Therapist BI-CG, relative to control, was greater on reductions in alcohol consumption in participants with moderate to severe symptoms of alcohol use disorder compared to those with mild symptoms. The effect of the Computer BI on alcohol use, relative to control, was greater among younger participants compared to older participants. CONCLUSIONS: While no overall effect was shown, ED-based Therapist BI-CG with computer guidance may be effective among patients with moderate-severe drinking patterns, whereas Computer BIs may be more effective for younger participants.
Authors: Nancy P Barnett; Timothy R Apodaca; Molly Magill; Suzanne M Colby; Chad Gwaltney; Damaris J Rohsenow; Peter M Monti Journal: Addiction Date: 2010-03 Impact factor: 6.526
Authors: Brooke J Arterberry; Alan K Davis; Maureen A Walton; Erin E Bonar; Rebecca M Cunningham; Frederic C Blow Journal: Addict Behav Date: 2019-04-22 Impact factor: 3.913
Authors: Lindsay R Meredith; Erica N Grodin; Mitchell P Karno; Amanda K Montoya; James MacKillop; Aaron C Lim; Lara A Ray Journal: Addict Sci Clin Pract Date: 2021-08-24
Authors: Andreas Staudt; Jennis Freyer-Adam; Christian Meyer; Gallus Bischof; Ulrich John; Sophie Baumann Journal: JMIR Public Health Surveill Date: 2022-06-30