Ann Emerg Med. 2007 Dec;50(6):699-710, 710.e1-6. doi: 10.1016/j.annemergmed.2007.06.486. Epub 2007 Sep 17.
We determine the impact of a screening, brief intervention, and referral for treatment (SBIRT) program in reducing alcohol consumption among emergency department (ED) patients.
Patients drinking above National Institute of Alcohol Abuse and Alcoholism low-risk guidelines were recruited from 14 sites nationwide from April to August 2004. A quasiexperimental comparison group design was used in which control and intervention patients were recruited sequentially at each site. Control patients received a written handout. The intervention group received the handout and a brief intervention, the Brief Negotiated Interview, to reduce unhealthy alcohol use. Follow-up surveys were conducted at 3 months by telephone using an interactive voice response system.
Of 7,751 patients screened, 2,051 (26%) exceeded the low-risk limits set by National Institute of Alcohol Abuse and Alcoholism; 1,132 (55%) of eligible patients consented and were enrolled (581 control, 551 intervention). Six hundred ninety-nine (62%) completed a 3-month follow-up survey, using the interactive voice response system. At follow-up, patients receiving a Brief Negotiated Interview reported consuming 3.25 fewer drinks per week than controls (coefficient [B] -3.25; 95% confidence interval [CI] -5.76 to -0.75), and the maximum number of drinks per occasion among those receiving Brief Negotiated Interview was almost three quarters of a drink less than controls (B -0.72; 95% CI -1.42 to -0.02). At-risk drinkers (CAGE <2) appeared to benefit more from a Brief Negotiated Interview than dependent drinkers (CAGE >2). At 3-month follow-up, 37.2% of patients with CAGE less than 2 in the intervention group no longer exceeded National Institute of Alcohol Abuse and Alcoholism low-risk limits compared with 18.6% in the control group (delta 18.6%; 95% CI 11.5% to 25.6%).
SBIRT appears effective in the ED setting for reducing unhealthy drinking at 3 months.
我们确定筛查、简短干预及转介治疗（SBIRT）项目对减少急诊科（ED）患者酒精摄入量的影响。
2004年4月至8月，从全国14个地点招募饮酒量超过美国国立酒精滥用与酒精中毒研究所低风险指南标准的患者。采用准实验对照组设计，在每个地点依次招募对照患者和干预患者。对照患者收到一份书面资料。干预组收到该资料并接受简短干预，即简短协商访谈，以减少不健康饮酒行为。3个月时通过电话使用交互式语音应答系统进行随访调查。
在接受筛查的7751名患者中，2051名（26%）超过了美国国立酒精滥用与酒精中毒研究所设定的低风险限值；1132名（55%）符合条件的患者同意并被纳入研究（581名对照患者，551名干预患者）。699名（62%）使用交互式语音应答系统完成了3个月的随访调查。随访时，接受简短协商访谈的患者报告每周饮酒量比对照组少3.25杯（系数[B] -3.25；95%置信区间[CI] -5.76至-0.75），接受简短协商访谈的患者每次饮酒的最大杯数比对照组少近四分之三杯（B -0.72；95% CI -1.42至-0.02）。有风险饮酒者（CAGE＜2）似乎比依赖饮酒者（CAGE＞2）从简短协商访谈中获益更多。在3个月随访时，干预组中CAGE小于2的患者有37.2%不再超过美国国立酒精滥用与酒精中毒研究所的低风险限值，而对照组为18.6%（差值18.6%；95% CI 11.5%至25.6%）。
SBIRT在急诊科环境中似乎能有效减少3个月时的不健康饮酒行为。
