Addictive Behaviors Unit, Clinical Neuroscience Institute, Hospital Clínic.
Department of Psychiatry and Clinical Psychobiology, University of Barcelona.
Eur J Emerg Med. 2021 Oct 1;28(5):373-379. doi: 10.1097/MEJ.0000000000000810.
SBIRT programs (Screening Brief Intervention and Referral to Treatment) for at-risk drinkers in emergency departments (ED) have shown to be effective, particularly at short term. In this article, we report mid and long-term follow-up results of a specialized SBIRT program. A short-term follow-up after 1.5 months showed encouraging results, with more than a 20% greater reduction of at-risk drinking in the intervention group and more than double of successful referrals to specialized treatment.
We aimed to evaluate the mid and long-term efficacy of an SBIRT program conducted by psychiatrist specialists in addictive disorders and motivational interviewing in the ED of a tertiary hospital.
DESIGN, SETTINGS AND PARTICIPANTS: We conducted a secondary analysis of a previously published randomized controlled trial of an SBIRT program conducted by alcohol specialists for at-risk drinkers presenting to the ED, measured with the AUDIT-C scale.
Patients were randomized into two groups, with the control group receiving two leaflets: one regarding alcohol use and the other giving information about the study protocol. The intervention group received the same leaflets as well as a brief motivational intervention on alcohol use and, where appropriate, a referral to specialized treatment.
Long-term assessment primary outcome was the proportion of at-risk alcohol use measured by AUDIT-C scale. The main effectiveness analysis at 18 weeks and 12 months' follow-up was conducted with multilevel logistic regression analyses. Missing values were imputed with the last observation carried forward.
Of 200 patients included in the study, 133 (66.5%) and 131 (65.5%) completed 18 weeks and 1-year follow-up respectively. Although the proportion of risky drinkers was substantially lower in the intervention group (38.5 vs. 57.4% at 4.5 months and 58.5 vs 68.2% at 1 year), these results did not reach statistical significance (OR = 2.15; CI, 0.87-5.33).
In this secondary analysis for mid- and long-term effects of a specialized SBIRT program, there was no significant difference in the reduction of risky drinkers at 18 weeks and 1 year. The small size of the studied sample and the low retention rate precluded any significant conclusion, although point estimates suggest a positive effect. Overall, SBIRT programs are an effective tool to reduce alcohol use at short time and to refer patients to specialized treatment; however, its effects seem to decay over time.
急诊科（ED）对高危饮酒者进行的 SBIRT 项目（筛查、简短干预和转介治疗）已被证明是有效的，尤其是在短期。在本文中，我们报告了一项专门的 SBIRT 项目的中期和长期随访结果。在 1.5 个月的短期随访后，结果令人鼓舞，干预组高危饮酒的减少超过 20%，成功转介到专门治疗的比例增加了一倍多。
我们旨在评估由精神病学专家和动机访谈在一家三级医院的急诊科进行的 SBIRT 项目的中期和长期疗效。
设计、设置和参与者：我们对以前发表的一项关于酒精专家对急诊科高危饮酒者进行 SBIRT 项目的随机对照试验进行了二次分析，使用 AUDIT-C 量表进行测量。
患者随机分为两组，对照组接受两份传单：一份关于酒精使用，另一份提供有关研究方案的信息。干预组除了接受相同的传单外，还接受了关于酒精使用的简短动机干预，如有必要，还会转介到专门的治疗。
长期评估的主要结果是通过 AUDIT-C 量表测量的高危酒精使用的比例。主要有效性分析在 18 周和 12 个月的随访中进行了多水平逻辑回归分析。缺失值采用最后观察值延续法进行插补。
在 200 名纳入研究的患者中，分别有 133 名（66.5%）和 131 名（65.5%）完成了 18 周和 1 年随访。尽管干预组高危饮酒者的比例明显降低（4.5 个月时为 38.5%，1 年后为 58.5%；1 年后为 58.5%，1 年后为 68.2%），但这些结果没有达到统计学意义（OR=2.15；CI，0.87-5.33）。
在这项专门的 SBIRT 项目中期和长期效果的二次分析中，在 18 周和 1 年时高危饮酒者的减少没有显著差异。研究样本量小和保留率低，无法得出任何有意义的结论，尽管点估计值表明有积极的效果。总体而言，SBIRT 项目是减少短期饮酒和转介患者接受专门治疗的有效工具；然而，其效果似乎随时间而衰减。
