Nordqvist Cecilia, Wilhelm Elisabeth, Lindqvist Kent, Bendtsen Preben
Department of Health and Society, Division of Social Medicine and Public Health Science, Linköping University, S-581 83 Linköping Sweden.
Alcohol Alcohol. 2005 Sep-Oct;40(5):401-8. doi: 10.1093/alcalc/agh175. Epub 2005 Jun 13.
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.
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.
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.
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.
急诊患者中存在风险饮酒者的比例过高的情况。尽管有证据表明简短的筛查反馈或自助材料是有效的，但迄今为止进行的大多数研究都需要工作人员投入大量时间，因此在现实世界中难以实施。本研究评估了筛查的效果以及简单的书面建议对风险饮酒是否有额外影响。
在瑞典一家急诊科对受伤患者实施了酒精筛查程序。在12个月的时间里，邀请了两组患者在候诊室回答酒精筛查问卷。在最初的6个月里，对771名患者进行了筛查，未提供任何书面建议（A组）；在接下来的6个月里，对563名患者进行了筛查，并且还收到了关于合理饮酒的简单书面建议（B组）。所有患者均未接受一对一反馈。筛查6个月后，通过电话随访访谈了解饮酒情况的变化。
A组中有182名（24%）患者被定义为风险饮酒者，B组中有125名（22%）。6个月随访时，A组中有81名（44%）风险饮酒者和278名（47%）非风险饮酒者被联系到，B组中有40名（32%）风险饮酒者和220名（50%）非风险饮酒者被联系到。A组中重度暴饮者的数量从76名（占风险饮酒者的94%）显著降至49名（59%）。B组也有类似变化，从37名（92%）降至27名（68%）。仅在B组中，改变饮酒习惯的意愿有显著增加[从3名（8%）增至9名（23%）]。重度暴饮的减少与先前更广泛干预措施的报告相当。然而，在随访时，基线时的非风险饮酒者饮酒量有所增加。考虑到非风险饮酒者数量较多，研究组在研究期间的总饮酒量有所增加。
鉴于报告中提到在急诊科整合更耗时的酒精干预措施存在困难，建议至少应将饮酒筛查作为急诊科的常规操作。为了在有效的酒精干预与工作人员可接受的时间和精力要求之间建立最佳平衡，还需要更多研究。
