Public Health and Primary CareORIGINAL ARTICLE

Emergency Department Screening and Intervention for Patients With Alcohol-Related Disorders: A Pilot Study

Aaron Craig Love, DO; Marna Rayl Greenberg, DO; Matthew Brice, DO; and Michael Weinstock, MD
Notes and Affiliations
Notes and Affiliations

Received: August 31, 2006

Accepted: November 1, 2006

Published: January 1, 2008

J Osteopath Med; 108(1): 12-20

Context: Physicians in emergency departments (EDs) treat more patients with alcohol-related disorders than do those in primary care settings.

Objectives: To implement an effective screening, brief intervention, and referral (SBIR) program for use in EDs. Further, to evaluate the impact of the program on alcohol-consumption levels.

Methods: A prospective cohort pilot study was conducted at a suburban community teaching hospital using a convenience sample of ED patients and an original seven-question screening tool based on well-known guidelines. Subjects screening positive for possible alcohol abuse were given treatment referrals. Follow-up telephone interviews were conducted 6 months later.

Results: Of the 1556 enrolled subjects, 251 (16%) were classified as at-risk drinkers. Seventy-nine at-risk subjects (32% [95% CI, 26%-37%]) screened positive on CAGE-based questions (Cut down, Annoyed, Guilty, Eye opener). At follow-up, 20 (25% [95% CI, 16%-35%]) were successfully contacted. Of these 20 subjects, 5 (25%) refused to participate in follow-up screening. For the remaining 15 individuals, follow-up screening indicated that the mean (SD) number of drinks consumed per week decreased from 28 (14) on study enrollment to 10 (10) at 6-month follow-up (P<.001). Maximum number of drinks per occasion decreased from 12 (8) at enrollment to 6 (7) on follow-up (P=.008). Subject scores on the CAGE-based questions decreased from pre- to postintervention, though not significantly, with an average of 2.1 (1) affirmative answers on enrollment and 1.5 (1.4) at follow-up (P=.108).

Conclusions: Implementation of an effective SBIR program for alcohol-related disorders can be accomplished in the ED.

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