Six-Month Follow-Up of Computerized Alcohol Screening, Brief Intervention, and Referral to Treatment in the Emergency Department

ABSTRACT

The goal of this observational study was to measure change in alcohol consumption at 6 months following emergency department computerized alcohol screening brief intervention (CASI) and referral to treatment (ED-SBIRT) with integrated brief negotiated interview (BNI) and computer-generated personal alcohol reduction plans. At-risk patients received a BNI by CASI, including personalized feedback, assessment of readiness to change, reasons for cutting down, goal setting, and a printed personal alcohol reduction plan. Alcohol use was assessed by telephone interview 6 months after CASI. Factors associated with lower alcohol consumption were examined. Of the 385 participants who completed the BNI, were consented, and enrolled, 221 subjects completed the 6-month follow-up interview. Forty-seven percent of the study sample of at-risk patients were no longer drinking over the National Institute on Alcohol Abuse and Alcoholism (NIAAA)-recommended limits. Reductions were greater for patients with Alcohol Use Disorders Identification Test (AUDIT) scores of 1 to 7. Readiness to change was a good predictor of drinking below the recommended limits. The use of computerized ED-SBIRT with integrated personalized messaging and BNI holds promise as a viable screening and intervention modality for a wide range of emergency department patients.

KEYWORDS:

• Alcohol
• brief intervention
• computer
• emergency department
• screening

Acknowledgments

This work was presented as an abstract at the 2008 SAEM Annual Meeting, May 29–June 1, Washington, DC.

This project was supported by a grant from the California Office of Traffic Safety. The authors would like to thank Christina Cheng and the University of California, Irvine, Emergency Medicine Research Associates Program for their help with this project.