Written Advice for Emergency Care Patients: Does It Work?November 4, 2005
Research Summary
Emergency care clinicians need pragmatic and effective methods to screen for and address risky drinking. In this study, Swedish researchers assessed whether emergency care patients may benefit from simple written advice about safer drinking. During the first half of the study, they screened 771 emergency care patients for risky drinking*; for the remaining half, they screened another 563 and provided written advice (without counseling). Researchers assessed alcohol measures at baseline and 6 months later (approximately 50 percent follow-up rate).- Approximately 23 percent of patients drank risky amounts at baseline.
- The proportion of risky drinkers with heavy drinking episodes** decreased significantly from baseline to follow-up in both groups (from 92 percent to 68 percent of those receiving written advice; from 94 percent to 59 percent of those receiving screening only).
- Among patients receiving written advice, the proportion of risky drinkers ready to change their drinking significantly increased (from 8 percent at baseline to 23 percent at follow-up).
Comments by Jeffrey Samet, MD, MA, MPH:This study showed that written advice does little to reduce risky drinking. The authors' contention that screening alone may have reduced the likelihood of heavy drinking episodes is suspect for several reasons (e.g., nonrandomized study design, limited follow-up). Further, fewer subjects may have had heavy drinking episodes because of their injury, not because they received alcohol screening. The search for an efficient alcohol intervention in the busy emergency setting still requires attention.
* Determined by the AUDIT-C and defined as heavy episodic drinking (see below) and/or approximately six or more drinks for women and nine or more drinks for men per week
** Six or more standard drinks at one occasion at least once per month
Reference:
Nordqvist C, Wilhelm E, Lindqvist K, et al. Can screening and simple written advice reduce excessive alcohol consumption among emergency care patients? Alcohol and Alcoholism. 2005;40(5):401-408.
Reprinted with permission from Alcohol and Health: Current Evidence.
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