The effect of computerized tailored brief advice on at-risk drinking in subcritically injured trauma patients.
Abstract
Background One-third of injured patients treated in the emergency department (ED) have an alcohol use disorder (AUD). Few are screened and receive counseling because ED staff have little time for additional tasks. We hypothesized that computer technology can screen and provide an intervention that reduces at-risk drinking (British Medical Association criteria) in injured ED patients. Methods In all, 3,026 subcritically injured patients admitted to an ED were screened for an AUD using a laptop computer that administered the AUD Identification Test (AUDIT) and assessed motivation to reduce drinking. Patients with a positive AUDIT (n = 1,139) were randomized to an intervention (n = 563) or control (n = 576) condition. The computer generated a customized printout based on the patient's own alcohol use pattern, level of motivation, and personal factors, which was provided in the form of feedback and advice. Results Most patients (85%) used the computer with minimal assistance. At study entry, a similar proportion in each group met criteria for at-risk drinking (49.6% versus 46.8%, p = 0.355). At 6 months, 21.7% of intervention and 30.4% of control patients met criteria for at-risk drinking (p = 0.008). Intervention patients also had a 35.7% decrease in alcohol intake, compared with a 20.5% decrease in controls (p = 0.006). At 12 months, alcohol intake decreased by 22.8% in the intervention group versus 10.9% in controls (p = 0.023), but the proportion of at-risk drinkers did not s…
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The evidence base for using brief interventions with emergency department patients is not strong.
“The data in ED settings are less clear.”
From A Brief Intervention Reduces Hazardous and Harmful Drinking in Emergency Department Patients (2012) · cites this paper as [24]
The Neumann study had a small, negative effect size of g = −0.14 (95% CI −0.41 to 0.15, random effects model).
“The second outlier was the Neumann study [54], with a small, negative effect size of g = −0.14 (95% CI −0.41 to 0.15, random effects model)”
From Effectiveness of E-self-help interventions for curbing adult problem drinking: a meta-analysis (2011) · cites this paper as [54]
In all but 3 studies all outcome measures were self-administered by participants, making it irrelevant whether the researchers assessing the outcomes were blinded to group assignment.
“In all but 3 studies [51,52,54] all outcome measures were self-administered by participants, making it irrelevant whether the researchers assessing the outcomes were blinded to group assignment.”
From Effectiveness of E-self-help interventions for curbing adult problem drinking: a meta-analysis (2011) · cites this paper as [54]
In 4 studies treatment was allocated by an independent third party; in 2 studies it was not, and in 3 studies this was unclear.
“In 4 studies [49,53,50,57], treatment was allocated by an independent third party; in 2 studies [31,45] it was not, and in 3 studies [51,52,54] this was unclear.”
From Effectiveness of E-self-help interventions for curbing adult problem drinking: a meta-analysis (2011) · cites this paper as [54]
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- Authors
- Neumann, T., Neuner, B., Weiss-Gerlach, E., T??nnesen, H., Gentilello, L. M., Wernecke, K. D., Schmidt, K., Schr??der, T., Wauer, H., Heinz, A., Mann, K., M??ller, J. M., Haas, N., Kox, W. J., & Spies, C. D.
- Affiliations
- Stiftung Charité (DE)
- Venue
- The Journal of Trauma: Injury, Infection, and Critical Care
- Published
- 2006-10
- Volume
- 61
- Issue
- 4
- Pages
- 805-814
- ISSN
- 0022-5282 (ISSN-L)
- OpenAlex
- W2088207190
- Cited by
- 159
- References
- 3
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 5 · 2019: 5 · 2018: 5 · 2017: 9 · 2016: 5 · 2015: 15 · 2014: 9 · 2013: 10 · 2012: 13
- FWCI
- 9.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Trauma: Injury, Infection, and Critical Care (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- 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
- hazardous drinking, alcoholism, trauma patients, emergency department, AUDIT screening, alcohol consumption reduction, automated feedback
- MeSH terms
- Adult, Alcoholism, Algorithms, Berlin, Computers, Counseling, Emergency Service, Hospital, Female, Humans, Male, Wounds and Injuries, Treatment Outcome
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