Preventive care in the emergency department: screening and brief intervention for alcohol problems in the emergency department: a systematic review

Author(s): D’Onofrio G, Degutis LC


Objective: To systematically review the medical literature in order to determine the strength of the recommendation for screening and brief intervention (SBI) for alcohol-related problems in the emergency department (ED) setting.

Methods: The review followed the methodology of systematic reviews and was facilitated through the use of a structured template, a companion explanatory piece, and a grading and methodological scoring system based on published criteria for critical appraisal. The primary outcome measure was the prevention of mortality and morbidity secondary to alcohol-related illnesses/injuries. The secondary outcome measures included: decreased consumption; fewer ED/outpatient visits and hospitalizations; a decrease in social consequences; and increased referrals for follow-up and/or treatment. Three Medline searches as well as a search of the Cochrane Library were performed. Two team members reviewed the abstracts and selected pertinent articles. References were screened for additional pertinent articles.

Results: Twenty-seven articles were identified and reviewed, in addition to the 14 primary articles included in the 1996 U.S. Preventive Services Task Force Report. The study populations were diverse, including inpatient, outpatient, and college settings, with ages ranging from 12 to 70 years. Four studies were ED-based and two included EDs as one of multiple sites. Thirty-nine studies on SBI, 30 randomized controlled and nine cohort, were used to formulate the current recommendation. A positive effect of the intervention was demonstrated in 32 of these studies.

Conclusions: The authors recommend that SBI for alcohol-related problems in the ED be incorporated into clinical practice.

Similar Articles

Substance-related problems in patients visiting an urban Canadian emergency department

Author(s): Brubacher JR, Mabie A, Ngo M, Abu-Laban RB, Buchanan J, et al.

Feasibility of screening and intervention for alcohol problems among young adults in the ED

Author(s): Hungerford DW, Williams JM, Furbee PM, Manley WG, Helmkamp JC, et al.

Rapid follow-up for patients after psychiatric crisis

Author(s): McCullumsmith C, Clark B, Blair C, Cropsey K, Shelton R

A review of research on the Alcohol Use Disorders Identification Test (AUDIT)

Author(s): Allen JP, Litten RZ, Fertig JB, Babor T

Evaluating the effects of a brief motivational intervention for injury drinkers in the Emergency Department

Author(s): Longabaugh R, Woolard RF, Nirenberg TD, Minugh AP, Becker B, et al.

Establishing treatment relations with alcoholics

Author(s): Chafetz ME, Blane HT, Abrams HS, Golner JH, Lacy E, et al.

The early history of ideas on brief interventions for alcohol

Author(s): McCambridge J, Cunningham JA

Individual and system influences on waiting time for substance abuse treatment

Author(s): Carr CJA, Xu J, Redko C, Lane DT, Rapp RC, et al.

Treatment barriers identified by substance abusers assessed at a centralized intake unit

Author(s): Rapp RC, Xu J, Carr CA, Lane DT, Wang J, et al.

Follow-up services after an emergency department visit for substance abuse

Author(s): Breton AR, Taira DA, Burns E, O´Leary J, Chung RS

Intervention by an alcohol health worker in an accident and emergency department

Author(s): Wright S, Moran L, Meyrick M, O’Connor R, Touquet R

Intervention attendance among Emergency Department patients with alcohol- and drug-use disorders

Author(s): Blow FC, Walton MA, Murray R, Cunningham RM, Chermack ST, et al.

Categorical Data Analysis using the SAS System

Author(s): Stokes ME, Davis CS, Koch GG