The effectiveness of brief intervention among injured patients with alcohol dependence: who benefits from brief interventions?

Field, Craig A.; Caetano, Raul

doi:10.1016/j.drugalcdep.2009.11.025

Cited by 53Substance Abuse Treatment and OutcomesAlcohol Consumption and Health EffectsBehavioral Health and Interventions

The effectiveness of brief intervention among injured patients with alcohol dependence: who benefits from brief interventions?

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Field, Craig A., Caetano, Raul·2010·Drug and Alcohol Dependence

DOI 10.1016/j.drugalcdep.2009.11.025PMC PMC2930034

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Abstract

Background Research investigating the differential effectiveness of Brief Motivational Interventions (BMIs) among alcohol-dependent and non-dependent patients in the medical setting is limited. Clinical guidelines suggest that BMI is most appropriate for patients with less severe alcohol problems. As a result, most studies evaluating the effectiveness of BMI have excluded patients with an indication of alcohol dependence.Methods A randomized controlled trial of brief intervention in the trauma care setting comparing BMI to treatment as usual plus assessment (TAU+) was conducted. Alcohol dependence status was determined for 1336 patients using DSM-IV diagnostic criteria. The differential effectiveness of BMI among alcohol-dependent and non-dependent patients was determined with regard to volume per week, maximum amount consumed, percent days abstinent, alcohol problems at 6 and 12 months follow-up. In addition, the effect of BMI on dependence status at 6 and 12 months was determined.Results There was a consistent interaction between BMI and alcohol dependence status, which indicated significantly higher reductions in volume per week at 6 and 12 months follow-up (beta=-.56, p=.03, beta=-.63, p=.02, respectively), maximum amount at 6 months (beta=-.31, p=.04), and significant decreases in percent days abstinent at 12 months (beta=.11, p=.007) and alcohol problems at 12 months (beta=-2.7, p(12)=.04) among patients with alcohol dependence receiving BMI. In addition, patients with alcohol dependence at baseline that received BMI were .59 (95% CI=.39-.91) times less likely to meet criteria for alcohol dependence at six months.Conclusions These findings suggest that BMI is more beneficial among patients with alcohol dependence who screen positive for an alcohol-related injury.

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Nine of the 13 trials reported improvement in at least one drinking-related outcome from brief intervention at one or more follow-up points.
“Nine of thirteen studies reported improvements in one or more drinking-related outcomes due to brief intervention at one or more time-points (55,57–59,61–65), and two studies did not examine drinking-related outcomes (56,60).”
From Specialty substance use disorder services following brief alcohol intervention: a meta-analysis of randomized controlled trials: SBI and referral to treatment (2015) · cites this paper as [58]
Only two trials measured self-reported alcohol treatment use with validated instruments.
“just two studies assessed self-reports of alcohol treatment utilization with validated instruments (33,58).”
From Specialty substance use disorder services following brief alcohol intervention: a meta-analysis of randomized controlled trials: SBI and referral to treatment (2015) · cites this paper as [58]
In 11 of 13 trials, treatment use meant receiving at least one specialty addiction treatment session; the other two trials counted specialty addiction treatment visits.
“In 11 of 13 studies, the presence of treatment utilization was defined as receiving one or more sessions of specialty addiction treatment (33,54,55,58–65), whereas the remaining two studies analyzed counts of specialty addiction treatment visits (56,57).”
From Specialty substance use disorder services following brief alcohol intervention: a meta-analysis of randomized controlled trials: SBI and referral to treatment (2015) · cites this paper as [58]
Many included trials described referral processes poorly or only gave participants lists of local alcohol treatment agencies.
“many of the identified studies were limited in their description of referral processes (56–58,64,65)”
From Specialty substance use disorder services following brief alcohol intervention: a meta-analysis of randomized controlled trials: SBI and referral to treatment (2015) · cites this paper as [58]
Interventions took place in medical inpatient units, general healthcare settings, and emergency departments.
“Interventions were delivered in medical inpatient units (33,54), general healthcare settings (55–57), and emergency departments (see Table 1) (58–65).”
From Specialty substance use disorder services following brief alcohol intervention: a meta-analysis of randomized controlled trials: SBI and referral to treatment (2015) · cites this paper as [58]

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Authors: Field, C. A., & Caetano, R.
Affiliations: University Medical Center Brackenridge (US)
Corresponding author: Field, Craig A.
ORCID: Field, Craig A.
Venue: Drug and Alcohol Dependence
Publisher: Elsevier BV
Published: 2010-09-01
Volume: 111
Issue: 1-2
Pages: 13-20
ISSN: 0376-8716 (ISSN-L)
DOI: 10.1016/j.drugalcdep.2009.11.025
PMC: PMC2930034
OpenAlex: W2043559560
Cited by: 53
References: 94
Citations by year: 2026: 1 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 1 · 2015: 10 · 2014: 4 · 2013: 6 · 2012: 7
FWCI: 3.96
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Drug and Alcohol Dependence (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health
U.S. Public Health Service (R01013824)
National Institute on Alcohol Abuse and Alcoholism (R01AA013824)
National Center on Minority Health and Health Disparities
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords: brief motivational intervention, alcoholism, trauma patients, alcohol-related injuries, alcohol consumption reduction, alcohol abstinence, alcohol problems, trauma care
MeSH terms: Adult, Alcoholism, Female, Humans, Male, Middle Aged, Motivation, Psychotherapy, Brief, Surveys and Questionnaires, Severity of Illness Index, Treatment Outcome, Patient Selection

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The effectiveness of brief intervention among injured patients with alcohol dependence: who benefits from brief interventions?

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