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Randomized controlled trial of mailed personalized feedback for problem drinkers in the emergency department: The short-term impact

journal contribution
posted on 02.11.2018, 00:00 authored by A Havard, AP Shakeshaft, KM Conigrave, Christopher DoranChristopher Doran
Background: 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. Methods: The intervention was evaluated with a randomized controlled trial of patients presenting to 5 rural EDs in New South Wales, Australia. Patients aged 14years 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. Results: Two hundred and forty-four (80%) participants were successfully followed up at 6weeks. 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. Conclusions: Mailed personalized feedback is efficacious in reducing quantity/frequency of alcohol consumption among patients with alcoh ol-involved ED presentations. Mailed feedback has high cost-efficacy and a low absolute cost, making it a promising candidate for integration into ED care. © 2011 by the Research Society on Alcoholism.

Funding

Category 2 - Other Public Sector Grants Category

History

Volume

36

Issue

3

Start Page

523

End Page

531

Number of Pages

9

eISSN

1530-0277

ISSN

0145-6008

Publisher

Wiley-Blackwell Publishing, Inc.

Peer Reviewed

Yes

Open Access

No

Acceptance Date

08/07/2011

External Author Affiliations

University of New South Wales

Era Eligible

Yes

Journal

Alcoholism: Clinical and Experimental Research