Screening, brief intervention, and referral to treatment (SBIRT): 12-month outcomes of a randomized controlled clinical trial in a Polish emergency department
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Background: A randomized controlled trial of screening, brief intervention, and referral to treatment (SBIRT) among at‐risk (based on average number of drinks per week and drinks per drinking day) and dependent drinkers was conducted in an emergency department (ED) among 446 patients 18 and older in Sosnowiec, Poland. Methods: Patients were recruited over a 23‐week period (4:00 pm to 12:00 midnight) and randomized to 1 of 3 conditions: screened‐only (n = 147), assessed (n = 152), and intervention (n = 147). Patients in the assessed and intervention conditions were blindly reassessed via a telephone interview at 3 months, and all 3 groups were assessed at 12 months (screened‐only = 92, assessed = 99, and intervention = 87). Results: No difference was found across the 3 conditions in at‐risk drinking at 12 months, as the primary outcome variable, or in decrease in the number of drinks per drinking day, with all 3 groups showing a significant reduction in both. Significant declines between baseline and 12 months in secondary outcomes of the RAPS4, number of drinking days per week, and the maximum number of drinks on an occasion were seen only for the intervention condition, and in negative consequences for both the assessment and intervention conditions. Conclusions: Data suggest that improvements in drinking outcomes found in the assessment condition were not because of assessment reactivity, with both the screened and intervention conditions demonstrating greater (although nonsignificant) improvement than the assessed condition. Only those in the intervention condition showed significant improvement in all outcome variables from baseline to 12‐month follow‐up. Although group by time interaction effects were not found to be significant, these findings suggest that declines in drinking measures for those receiving a brief intervention can be maintained at long‐term follow‐up.
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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).”
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).”
Trials in emergency departments or with mixed-severity samples had lower post-intervention alcohol treatment use, with 1.9-32.8% of intervention participants receiving treatment.
“In comparison, studies conducted in emergency departments and/or with mixed severity samples had a lower range of post-intervention alcohol treatment utilization (1.9–32.8% in the intervention groups obtained alcohol treatment) (59–63,66).”
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).”
All eight trials with a referral-specific intervention gave information about community alcohol treatment options, and three described more active efforts to encourage help seeking.
“All of these eight studies provided information about alcohol treatment options in the community (54,59–65), and three of them described more active efforts to encourage help seeking.”
Six of the eight trials with referral-specific efforts kept those efforts in the intervention group only, while two gave the same information to the control group.
“In total, six of the eight studies with referral-specific efforts isolated these referral-specific efforts to the intervention group (54,59–63). The other two of studies only provided information about treatment options as the referral-specific effort, but provided the same information to the control group (64,65).”
Most interventions used brief advice or a motivational interview; some added counseling or booster sessions; one had no in-person contact and mailed a letter asking participants to book an appointment with a specialist.
“The majority of interventions involved brief advice or a motivational interview (33,54,58,59,61,62,64–66), several offered additional counseling or booster intervention sessions (55,57,61,66), and one intervention had no in-person contact and simply mailed a letter to participants requesting they make an appointment with a specialist (60).”
Four trials were conducted outside the United States, in France, Germany, Poland, and Australia.
“Four RCTs were conducted outside of the United States, including France, Germany, Poland, and Australia (55,57,59,60).”
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- Authors
- Cherpitel, C. J., Korcha, R. A., Moskalewicz, J., Swiatkiewicz, G., Ye, Y., & Bond, J.
- Affiliations
- Alcohol Research Group (US)
- Corresponding author
- Cherpitel, Cheryl J.
- Venue
- Alcoholism: Clinical and Experimental Research
- Publisher
- Wiley
- Published
- 2010-10-26
- Volume
- 34
- Issue
- 11
- Pages
- 1922-1928
- ISSN
- 0145-6008 (ISSN-L)
- 1530-0277
- PMC
- PMC2965307
- OpenAlex
- W1498603615
- Semantic Scholar
- c4fd2f731d0cbf7685c5f1992ff51e9f558bed4e
- Cited by
- 45
- References
- 21
- Citations by year
- 2025: 1 · 2023: 1 · 2021: 1 · 2019: 3 · 2018: 3 · 2017: 7 · 2016: 4 · 2015: 8 · 2014: 5 · 2013: 2 · 2012: 4
- FWCI
- 2.79
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Alcoholism Clinical and Experimental Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R21AA016081)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- SBIRT, alcoholism, emergency department patients, hazardous drinking, brief intervention, long-term outcomes, alcohol-related consequences, alcohol screening
- MeSH terms
- Adult, Alcohol Drinking, Alcoholism, Data Interpretation, Statistical, Emergency Service, Hospital, Female, Follow-Up Studies, Humans, Male, Middle Aged, Patient Dropouts, Poland, Referral and Consultation, Sex Factors, Trauma Centers, Treatment Outcome, Patient Selection
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