National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
Alcohol Clin Exp Res. 2012 Mar;36(3):523-31. doi: 10.1111/j.1530-0277.2011.01632.x. Epub 2011 Oct 20.
Evidence exists for the efficacy of emergency department (ED)-based brief alcohol interventions, but attempts to incorporate face-to-face interventions into routine ED practice have been hampered by time, financial, and attitudinal constraints. Mailed personalized feedback, which is likely to be more feasible, has been associated with reduced alcohol consumption in other settings, but its cost-effectiveness in the ED has not been examined.
The intervention was evaluated with a randomized controlled trial of patients presenting to 5 rural EDs in New South Wales, Australia. Patients aged 14 years and older were screened using the Alcohol Use Disorders Identification Test, and those scoring 8 or more were randomly allocated to the intervention or control group. Participants in the intervention group received mailed personalized feedback regarding their alcohol consumption. The control group received no feedback.
Two hundred and forty-four (80%) participants were successfully followed up at 6 weeks. A significant effect of the mailed feedback was observed only in patients with an alcohol-involved ED presentation. Among this subgroup of participants, those in the intervention group consumed 12.2 fewer drinks per week than the control group after controlling for baseline consumption and other covariates (effect size d = 0.59). The intervention was associated with an average cost of Australian $5.83 per patient, and among participants with an alcohol-involved ED presentation, an incremental cost-effectiveness ratio of 0.48.
Mailed personalized feedback is efficacious in reducing quantity/frequency of alcohol consumption among patients with alcohol-involved ED presentations. Mailed feedback has high cost-efficacy and a low absolute cost, making it a promising candidate for integration into ED care.
已有证据表明，在急诊科（ED）进行的简短酒精干预是有效的，但由于时间、财务和态度等限制，试图将面对面干预纳入常规 ED 实践一直受到阻碍。邮寄个性化反馈可能更可行，在其他环境中与减少饮酒量有关，但尚未在 ED 中对其成本效益进行检验。
该干预措施在澳大利亚新南威尔士州 5 家农村 ED 进行的一项随机对照试验中进行了评估。使用酒精使用障碍识别测试对年龄在 14 岁及以上的患者进行筛查，得分 8 分或以上的患者被随机分配到干预组或对照组。干预组的参与者收到有关其饮酒量的邮寄个性化反馈。对照组未收到反馈。
244 名（80%）患者成功在 6 周时进行了随访。仅在有酒精相关 ED 就诊的患者中观察到邮寄反馈的显著效果。在这组亚组参与者中，在控制基线饮酒量和其他协变量后，干预组每周饮酒量比对照组少 12.2 杯（效应大小 d = 0.59）。干预的平均每位患者成本为澳大利亚 5.83 美元，在有酒精相关 ED 就诊的参与者中，增量成本效益比为 0.48。
邮寄个性化反馈可有效减少有酒精相关 ED 就诊的患者的饮酒量/频率。邮寄反馈具有高成本效益和低绝对成本，使其成为整合到 ED 护理中的有前途的候选方案。
