Brief interventions for heavy alcohol users admitted to general hospital wards

  • Review
  • Intervention

Authors


Abstract

Background

Brief interventions involve a time-limited intervention focusing on changing behaviour. They are often motivational in nature using counselling skills to encourage a reduction in alcohol consumption.

Objectives

To determine whether brief interventions reduce alcohol consumption and improve outcomes for heavy alcohol users admitted to general hospital inpatient units.

Search strategy

We searched the Cochrane Drug and Alcohol Group Register of Trials (June 2008) the Cochrane Central Register of Controlled Trials (The Cochrane Library 2, 2008), MEDLINE January 1966-June 2008, CINAHL 1982-June 2008, EMBASE 1980-June 2008 using the search strategy developed by the Cochrane Drug and Alcohol Group. We hand searched relevant journals, conference proceedings and contacted experts in the field.

Selection criteria

All prospective randomised controlled trials and controlled clinical trials were eligible for inclusion. Participants were adults (16 years or older) admitted to general inpatient hospital care for any reason other than specifically for alcohol treatment and received brief interventions (of up to 3 sessions) compared to no or regular treatment.

Data collection and analysis

Three reviewers independently selected the studies and extracted data. Where appropriate random effects meta-analysis and sensitivity analysis were performed.

Main results

Eleven studies involving 2441 participants were included in this review. Three results were non significant and one result was significant mean alcohol consumption per week change scores from baseline (P0.02).

Authors' conclusions

The evidence for brief interventions delivered to heavy alcohol users admitted to general hospital is still inconclusive. From data extracted from two studies it appears that alcohol consumption could be reduced at one year follow up though further research is recommended. Few studies have been retrieved and the results were difficult to combine because of the different measures used to assess alcohol consumption.

Plain language summary

Brief interventions for heavy alcohol users admitted to general hospital wards

Heavy or dangerous patterns of drinking alcohol can lead to accidents, injuries, physical and psychiatric illnesses, frequent sickness, absence from employment and social problems. Long term alcohol consumption has harmful effects on almost all organs of the body, particularly the brain and gastro-intestinal system. Healthcare professionals have the opportunity to ask people about how much alcohol they drink and offer brief interventions to heavy drinkers. These brief interventions involve a time limited intervention focusing on changing behaviour. They range from a single session providing information and advice to one to three sessions of motivational interviewing or skills-based counseling involving feedback and discussion on responsibility and self efficacy. Different health professionals may give the intervention. Admission to hospital as an inpatient, in general medical wards and trauma centres, provides an opportunity whereby heavy alcohol users are accessible, have time for an intervention, and may be made aware of any links between their hospitalisation and alcohol. The review authors identified 11 randomised controlled trials and controlled clinical trials involving 2441 adults (16 years or older) identified as heavy drinkers in hospital, mainly in the UK and USA.

Data extracted from two studies indicated that alcohol consumption could be reduced at one year follow up for people who received brief interventions as inpatients. These people drank significantly less alcohol per week than those in the control groups. A trend was observed towards consuming less grammes of alcohol per week at six months in those receiving the brief intervention. No clear differences were observed between the brief intervention and control groups for self reports of alcohol consumption, laboratory markers (GammaGT), number of binges, death or driving offences. The results of the studies were difficult to combine because of the different measures used to assess alcohol consumption and substantial variations in how the studies were carried out.

Control groups received assessment (screening) only or usual care, one with an educational leaflet. Screening involves asking people about their drinking patterns, which may have reduced drinking in the short term, as indicated in some of the studies.

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