Alcohol and Alcoholism Advance Access originally published online on June 13, 2005
Alcohol and Alcoholism 2005 40(5):401-408; doi:10.1093/alcalc/agh175
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CAN SCREENING AND SIMPLE WRITTEN ADVICE REDUCE EXCESSIVE ALCOHOL CONSUMPTION AMONG EMERGENCY CARE PATIENTS?
Department of Health and Society, Division of Social Medicine and Public Health Science, Linköping University, S-581 83 Linköping, Sweden
* Author to whom correspondence should be addressed at: Department of Health and Society, Division of Social Medicine and Public Health Science, Linköping University, S-581 83 Linköping, Sweden. Tel.: +46 13 22 51 10; Fax: +46 13 22 18 65; E-mail: cecno{at}ihs.liu.se
(Received 10 November 2004; first review notified 8 March 2005; in revised form 25 April 2005; accepted 18 May 2005)
Aims: Emergency care patients have an overrepresentation of risky drinkers. Despite the evidence on the effectiveness of a short feedback on screening or self-help material, most studies performed so far have required considerable time from staff and thus been difficult to implement in the real world. The present study evaluates the effect of the screening and whether simple written advice has any additional effect on risky drinking. Methods: An alcohol screening routine was implemented among injury patients in a Swedish emergency care department. Over 12 months, two cohorts were invited to answer an alcohol screening questionnaire in the waiting room. In the first 6 months, 771 patients were screened without any written advice (cohort A) and in the following 6 months, 563 were screened and in addition received simple written advice about sensible drinking (cohort B). None of the patients received one-to-one feedback. Six months after the screening, a follow-up interview by telephone explored the changes in drinking. Results: In cohort A 182 (24%) of the patients were defined as risky drinkers and in cohort B 125 (22%). Reached at follow-up after 6 months were 81 (44%) risky and 278 (47%) non-risky drinkers in cohort A, and 40 (32%) risky and 220 (50%) non-risky drinkers in cohort B. The number of patients with heavy episodic drinking decreased significantly in cohort A from 76 (94% of the risky drinkers) to 49 (59%). In cohort B a similar change was seen from 37 (92%) to 27 (68%). Only in cohort B, was a significant increase in readiness to change drinking habits seen [from 3 (8%) to 9 (23%)]. The reduction in heavy episodic drinking was comparable with previous reports from more extensive interventions. However, at the time of follow-up, drinking among non-risky drinkers at baseline had increased. When considering the greater numbers of non-risky drinkers, the total consumption in the study group increased during the study period. Conclusions: Owing to the reported difficulties of integrating more time-consuming alcohol interventions in emergency departments, it is suggested that at least screening for drinking should be implemented as routine in emergency departments. More research is needed in order to establish the optimal balance between effective alcohol intervention, and acceptable time and effort requirement from staff.