Journal review

Hungerford DW, Pollock DA, Knox TH. Acceptability of emergency department-based screening and brief intervention for alcohol problems. Acad Emerg Med 2000; 7:1,383-1,392.

Patients with mild to moderate alcohol problems can be helped through brief screening and intervention in the ED, says this study from the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, and Emory University School of Medicine, all based in Atlanta. Patients were screened using an Alcohol Use Disorders Identification Test (AUDIT). Patients who screened positive for alcohol problems were given brief, on-site counseling and referral. Here are key findings of the study:

• Of 1,034 patients approached, 78.3% (810) agreed to participate after being informed they would be asked specifically about alcohol problems.

• Of these patients, 21.2% (172) screened positive for mild to moderate alcohol problems.

• Out of 88 patients who screened positive for alcohol problems, 94.3% (83) of patients accepted an intervention (a brief counseling session), and most set goals to decrease or stop drinking.

• Of 23 patients who were contacted again, most reported significant decreases in alcohol intake and dependence symptoms.

Overall, the researchers found high consent rates for participation, acceptance of brief counseling, willingness to set goals to decrease drinking, and satisfaction in follow-up interviews.

The researchers used dedicated staff who had time to screen patients and provide counseling. "The protocol was acceptable to ED staff because it neither interfered with clinical operations nor increased workload for current ED staff," they note.