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Systematic review and meta-analyses of strategies targeting alcohol problems in emergency departments: interventions reduce alcohol-related injuries.
Abstract
Aims To critique the methodological adequacy of evaluations of emergency department (ED)-based interventions for alcohol problems and to conduct a meta-analysis to examine the extent to which interventions in this setting are effective in reducing alcohol consumption and related harm. Methods An electronic search of 11 databases and a manual search of reference lists were conducted to identify studies published in peer-review journals between January 1996 and July 2007 (inclusive). Studies evaluating the outcome of an intervention designed to reduce alcohol problems in patients presenting to the ED were eligible for inclusion. Methodological data were extracted using review criteria adapted from the both the Center for Disease Control (CDC) Guide to Community Preventive Services Data Collection Instrument and the Cochrane Effective Practice and Organization of Care Review Group Data Collection Checklist. Continuous outcomes were pooled using a fixed effect inverse variance approach while binary outcomes were pooled in a generic inverse variance meta-analysis. Results Thirteen studies were identified for inclusion in the review. Methodological quality was found to be reasonable, with the exception of poor reporting of effect-size information and inconsistent selection of outcome measures. Meta-analyses revealed that interventions did not significantly reduce subsequent alcohol consumption, but were associated with approximately half the odds of experiencing an alcohol-related…
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“A recent meta-analysis of strategies targeting alcohol problems in the ED found that BI did not significantly reduce drinking but was associated with a 50% reduction in alcohol-related injury.25”
From A Brief Intervention Reduces Hazardous and Harmful Drinking in Emergency Department Patients (2012) · cites this paper as [25]
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Could an advance practice nurse improve detection of alcohol misuse in the emergency department?
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“While services such as these vary in their operational timeframes from 16/24 h (morning and evening services),(34) to nightshifts(35) or approximately 20/24 h,(36) they have shown to be effective in expediting(34,35) and enhancing assessment and referral services, improving inter-disciplinary relationships and providi…”
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“These brief interventions have been extensively studied in medical inpatients, patients with trauma, and patients in the emergency department [14-16].”
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“These results were confirmed in settings such as emergency services [17] and practitioners’ clinics [18], as well as in various adolescent populations [19].”
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“Behavioural beliefs Patient’s health will improve 71 (17) Might improve the patient’s safety and the safety of others 67 (17) Might help decrease repeat alcohol-related presentations to the ED 61 (7) Might increase the patient’s motivation to change their alcohol consumption 60 (14) Patient might learn to manage their…”
Spreading alcohol brief interventions from health care to non-health care settings: Is it justified?
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“(Bien et al. 1993; Burke et al. 2003; Dunn et al. 2001) Brief intervention approaches have been also used among ED patients admitted to hospital (Dyehouse and Sommers 1995; Welte et al. 1998) and on injured patients in the ED. (Bazargan-Hejazi et al. 2005; Blow et al. 2006; Gentilello et al. 1999; Havard et al. 2008;…”
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“Patient management approaches using the SBIRT model (Screening, Brief Intervention, Referral to Treatment) have been evaluated in the ED with mixed impact [9, 10].”
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“Competing perspectives have been used to account for the comorbidity between anxiety and substance use disorders (SUD): (1) anxiety symptomology promotes SUDs, (2) SUDs promote anxiety problems, (3) a third, common factor promotes both anxiety and problematic substance use, and (4) there are bidirectional effects of a…”
BackgroundAlcohol as a Factor in 911 Calls in Denver
Joseph, D., Vogel, J. A., Smith, C., Barrett, W. J., Bryskiewicz, G., Eberhardt, A. M., Edwards, D., Rappaport, L. D., Colwell, C. B., & McVaney, K. E. (2018) · Prehospital Emergency Care · doi:10.1080/10903127.2017.1413467 · Cited by 6
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“Systematic reviews of alcohol screening and brief intervention in hospital and emergency settings find mixed results and do not consistently demonstrate efficacy.(22) 23 Furthermore, systematic reviews find that repeated interventions but not single ones have efficacy, little association between duration of interventi…”
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“Thus, programs that address both drug use and HIV risk reduction may be beneficial, although further research is needed (Bazargan-Hejazi et al., 2005; Carey et al., 2012; Darker et al., 2012; Harris and Knight, 2014; Havard et al., 2008; Longabaugh et al., 2001; Monti et al., 2007; Nilsen et al., 2008).”
BackgroundEffects of brief intervention on subgroups of injured patients who drink at risk levels
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“This supports the investment of time in preventive work against substance use during treatment of the injury in order to minimize subsequent readmissions (Havard et al., 2008).”
BackgroundLatent Classes Among Recipients of a Brief Alcohol Intervention: A Replication Analysis
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“Screening and brief intervention (SBI) is a method to help patients who drink at or above risk levels (ie, men: 5 drinks/day or 15 drinks/week; women: 4 drinks/day or 8 drinks/week)(1) to reduce use and to prevent alcoholrelated behaviors that often precede injury.(2,3) SBI includes screening patients for risk-level a…”
BackgroundMethodMartino, S., Zimbrean, P. C., Forray, A., Kaufman, J. S., Desan, P. H., Olmstead, T. A., Gueorguieva, R. V., Howell, H. B., McCaherty, A., & Yonkers, K. A. (2015) · Implementation Science · doi:10.1186/s13012-015-0327-9 · Cited by 5
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Substance Misuse in the Psychiatric Emergency Service; A Descriptive Study
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Maynard, K. R., & Paton, S. (2012) · Kōtuitui New Zealand Journal of Social Sciences Online · doi:10.1080/1177083x.2012.725418 · Cited by 3
“…shown decreased emergency department visits and hospitalisations (Irvin 2000; D’Onofior & Degutis 2002) and a halving of the odds of sustaining an alcohol-related injury in the 6 to 12 months following presentation at an emergency department and receiving a brief intervention (Havard et al. 2008).”
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McCormack, R. P. (2017) · Addiction · doi:10.1111/add.13872 · Cited by 4
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Lee, K. H., Dastaran, M., & Chandu, A. (2017) · Oral and Maxillofacial Surgery · doi:10.1007/s10006-017-0621-6 · Cited by 7
Underage drinking, brief interventions, and trauma patients
Ehrlich, P. F., Roche, J., Cunningham, R. M., Chermack, S. T., Carter, P. M., Booth, B. M., Blow, F. C., Barry, K. L., & Walton, M. A. (2016) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000001093 · Cited by 4
“Other adult SBIRT studies have shown a reduction in consequences, but not consumption.(12) In pediatric patients, alcohol BIs have been shown to be efficacious and feasible across many settings, including in EDs and trauma centers.”
BackgroundAlcohol-related brain damage (ARBD): a service need
Aziz, V. (2014) · International Psychogeriatrics · doi:10.1017/s1041610214001252 · Cited by 4
“They can be involved in the prevention and management of alcohol use, in raising awareness about alcohol-related conditions, facilitating referral, and providing immediate support for those who have problematic alcohol use (Moyer et al., 2002; Emmen et al., 2004; Guth et al., 2008; Havard et al., 2008).”
BackgroundRisk Factors for Subsequent Impaired Driving by Injured Passengers
Purssell, R., Chan, H., Brown, D., Fang, M., & Brubacher, J. (2014) · Traffic Injury Prevention · doi:10.1080/15389588.2013.822966 · Cited by 4
“Havard et al. (2008) completed a systematic review and metaanalysis and concluded that individuals undergoing ED-based interventions, compared to those receiving standard care, had approximately half (0.59) the odds of sustaining an alcoholrelated injury in the 6 and 12 months following their ED…”
MethodInfluentialThe Prevention of Alcohol Problems
Saunders, J. B., & Latt, N. C. (2009) · Wiley eBooks · doi:10.1002/9780470975084.ch11 · Cited by 20
The case for extended brief interventions
Heather, N. (2011) · Slovenian Journal of Public Health · doi:10.2478/v10152-010-0023-8 · Cited by 5
Identification and Treatment of Alcohol or Drug Dependence in the Elderly
Blow, F. C., & Barry, K. L. (2010) · Springer eBooks · doi:10.1007/978-1-4419-0338-9_70 · Cited by 2
Scheuermeyer, F., Lane, D., Grunau, B., Grafstein, E., Miles, I., Kestler, A., Barbic, D., Barbic, S., Slvjic, I., Duley, S., et al. (2023) · Canadian Journal of Emergency Medicine · doi:10.1007/s43678-022-00414-w · Cited by 3
Coughlin, L. N., Blow, F. C., Walton, M. A., Ignacio, R. V., Walters, H., Massey, L. S., Barry, K. L., & McCormick, R. (2021) · JMIR Mental Health · doi:10.2196/29397 · Cited by 4
“There is strong evidence in the civilian literature on the efficacy of BIs for adults with at-risk or harmful levels of drinking [42-44], but this approach has not been well studied in military populations.”
BackgroundRuben, J. P., Paul, V., Nicholas, A. V., Devarbhavi, H. C., Patil, M., Selvam, S., & Mysore, A. V. (2021) · Alcoholism Treatment Quarterly · doi:10.1080/07347324.2021.1901633 · Cited by 4
Lappin, J., Ayub, M., Rogers, D., Morgan, M., Kanyamibwa, J.-Y., & Shakeshaft, A. (2018) · Emergency Medicine Australasia · doi:10.1111/1742-6723.12959 · Cited by 3
Self-citationThe Triage Process for Behavioral Emergencies
Chepenik, L. G. (2017) · Current Emergency and Hospital Medicine Reports · doi:10.1007/s40138-017-0140-7 · Cited by 2
Merchant, R. C., Liu, T., & Baird, J. R. (2016) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2016.3.29723 · Cited by 3
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Cowan, E., Eiting, E., O'Brien-Lambert, C., Ryder, J., & Calderon, Y. (2025) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2025.03.001 · Cited by 2
Kuwabara, Y., Kinjo, A., Fujii, M., Minobe, R., Maesato, H., Higuchi, S., Yoshimoto, H., Jike, M., Otsuka, Y., Itani, O., et al. (2021) · Yonago acta medica · doi:10.33160/yam.2021.11.002 · Cited by 1
Vaca, F. E., Dziura, J. D., Abujarad, F., Pantalon, M. V., Hsiao, A., Field, C. A., & D’Onofrio, G. (2020) · Contemporary Clinical Trials · doi:10.1016/j.cct.2020.106104
“ED visits provide unique opportunity to identify, intervene, initiate treatment, and address alcohol-related health disparities among those with AUDs, particularly in more vulnerable populations [27].”
BackgroundBaldacchino, A., O’Rourke, L., & Humphris, G. M. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.03.035 · Cited by 3
Would brief alcohol intervention be helpful in facial trauma patients?A Narrative Review
Lee, K. H., & Hughes, A. J. (2017) · Oral and Maxillofacial Surgery · doi:10.1007/s10006-017-0639-9 · Cited by 2
Brief Interventions and Motivational Interviewing
Hettema, J. E., Wagner, C. C., Ingersoll, K. S., & Russo, J. M. (2014) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199381708.013.007 · Cited by 7
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Drug and alcohol addiction: do psychosocial treatments work?
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van Gaalen, A., & Laurant, M. G. H. (2012) · Nederlands Tijdschrift voor Evidence Based Practice · doi:10.1007/s12468-012-0026-3 · Cited by 2
Hazardous drinking among patients attending a minor injuries unit: a pilot study
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Alcohol and injury in Poland: review and training recommendations
Woźniak, P., Cunningham, R. M., Kamat, S. V., Barry, K. L., Blow, F. C., & Zawadzki, A. S. (2010) · International Journal of Emergency Medicine · doi:10.1007/s12245-010-0169-9 · Cited by 2
Screening, Early Detection, and Brief Intervention of Alcohol Use Disorders
Saunders, J. B., & Latt, N. C. (2020) · Springer eBooks · doi:10.1007/978-3-030-36391-8_40 · Cited by 4
Trapped in a maze: A meta-ethnography of women's experiences of alcohol use in pregnancy
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Metadata
- Authors
- Havard, A., Shakeshaft, A., & Sanson‐Fisher, R.
- Affiliations
- UNSW Sydney (AU)
- University of Newcastle Australia (AU)
- Corresponding author
- Havard, Alys
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2008-01-09
- Volume
- 103
- Issue
- 3
- Pages
- 368-376
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W2136540139
- Cited by
- 250
- References
- 49
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 7 · 2023: 5 · 2022: 3 · 2021: 9 · 2020: 8 · 2019: 5 · 2018: 10 · 2017: 20 · 2016: 13 · 2015: 31 · 2014: 27 · 2013: 21 · 2012: 27
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- NOVA (University of Newcastle Australia) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- alcohol problems, emergency department interventions, alcohol-related injuries, alcohol consumption, harm reduction, intervention effectiveness, methodological quality, outcome measures, effect size reporting
- MeSH terms
- Alcohol Drinking, Emergency Service, Hospital, Humans, Research Design, Wounds and Injuries, Alcohol-Related Disorders
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