D’Onofrio G, Degutis LC. Screening and brief intervention for alcohol problems in the emergency department: A systematic review. Acad Emerg Med 2002; 9:627-638.
Screening and brief intervention (SBI) for alcohol problems should be incorporated into your clinical practice, says this study from Yale University School of Medicine in New Haven, CT. The authors set out to determine the strength of the recommendation for SBI from the U.S. Preventive Services Task force, which in 1996 assigned it a "B" level recommendation (indicating "fair" evidence) for adult, adolescent, and pregnant patients.
They found that a positive effect of this practice was identified in 32 of the studies, including four specifically in the ED and two which included the ED.
Therefore, the authors recommend that screening and brief intervention be assigned an "A" rating (indicating "good" evidence) because the evidence is so strong. Here are some of their conclusions from the studies reviewed:
• Because the ED intervention must be brief, it can be limited to having patients accept a referral and agreeing to comply with medical treatment.
• Research shows that a group of patients who participated in a single 30-minute intervention had a 47% reduction in injuries requiring ED or hospital admission at one-year follow-up. Therefore, injured patients who are discharged from the ED may benefit from a brief intervention.
• Brief interventions with adolescents were effective in decreasing alcohol consumption, but also were effective in decreasing alcohol-related problems including drinking and driving and alcohol-related injuries.
• Research shows that nonprofessionals such as community outreach workers can be successfully trained to screen and intervene. (For more information on alcohol screening, see "Do you screen patients for alcohol abuse?" ED Nursing, June 2002, p. 104.)
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