University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030-3910, USA.
Alcohol Alcohol. 2010 Nov-Dec;45(6):514-9. doi: 10.1093/alcalc/agq058. Epub 2010 Sep 27.
This study aims to determine the impact of Screening, Brief Intervention and Referral for Treatment (SBIRT) in reducing alcohol consumption in emergency department (ED) patients at 3, 6, and 12 months following exposure to the intervention.
Patients drinking above the low-risk limits (at-risk to dependence), as defined by National Institute of Alcohol Abuse and Alcoholism (NIAAA), were recruited from 14 sites nationwide from April to August 2004. A quasi-experimental comparison group design included sequential recruitment of intervention and control patients at each site. Control patients received a written handout. The Intervention group received the handout and participated in a brief negotiated interview with direct referral for treatment if indicated. Follow-up surveys were conducted at 3, 6, and 12 months by telephone using an Interactive Voice Response (IVR) system.
Of the 1132 eligible patients consented and enrolled (581 control, 551 intervention), 699 (63%), 575 (52%) and 433 (38%) completed follow-up surveys via IVR at 3, 6, and 12 months, respectively. Regression analysis adjusting for the clustered sampling design and using multiple imputation procedures to account for subject attrition revealed that those receiving SBIRT reported roughly three drinks less per week than controls (B = -3.00, SE = 1.06, P < 0.05) and the level of maximum drinks per occasion was approximately three-fourths of a drink less than controls (B = -0.76, SE = 0.29, P < 0.05) at 3 months. At 6 and 12 months post-intervention, these effects had weakened considerably and were no longer statistically or substantively significant.
SBIRT delivered by ED providers appears to have short-term effectiveness in reducing at-risk drinking, but multi-contact interventions or booster programs may be necessary to maintain long-term reductions in risky drinking.
本研究旨在确定在接触干预措施后 3、6 和 12 个月，通过筛查、简短干预和转介治疗（SBIRT）减少急诊科（ED）患者饮酒量的效果。
从 2004 年 4 月至 8 月，在全国 14 个地点招募了饮酒量超过国家酒精滥用与酒精中毒研究所（NIAAA）定义的低危限（有依赖风险）的患者。采用准实验性比较组设计，在每个地点连续招募干预组和对照组患者。对照组患者接受书面传单。干预组患者收到传单，并在有需要时接受简短的协商面谈，并直接转介治疗。通过交互式语音应答（IVR）系统在 3、6 和 12 个月时进行电话随访调查。
在符合条件并入组的 1132 名患者中（对照组 581 例，干预组 551 例），分别有 699 例（63%）、575 例（52%）和 433 例（38%）通过 IVR 在 3、6 和 12 个月时完成了随访调查。使用聚类抽样设计进行回归分析，并采用多重插补程序来考虑受试者流失情况，结果显示，接受 SBIRT 的患者每周饮酒量比对照组少约 3 杯（B=-3.00，SE=1.06，P<0.05），最大饮酒量也比对照组少约 3/4 杯（B=-0.76，SE=0.29，P<0.05），在 3 个月时。在干预后 6 个月和 12 个月时，这些效果明显减弱，不再具有统计学或实质性意义。
ED 医护人员提供的 SBIRT 似乎在短期内有效减少有风险的饮酒行为，但可能需要多接触干预或强化计划来维持长期减少危险饮酒行为。
