Brief E.R. Intervention Helps Reduce Drinking

A nationwide study of 7,751 emergency room patients has confirmed that visits to the E.R. provide a great opportunity to use brief interventions to reduce harmful drinking. Asking emergency department patients about their alcohol use and talking with them about how to reduce harmful drinking patterns is effective in reducing drinking, the study found.

In the study, conducted at 14 university-based emergency centers, researchers use a brief questionnaire to access the alcohol consumption of 7,751 patients, even if they had no signs of alcohol use when they were admitted. They found one-fourth of the patients qualified as harmful drinkers -- four drinks a day for men, three for women.

Of those patients, 1,100 agreed to participate in the study. They were divided into two groups, on e receiving intervention and one control group. Their drinking patterns were assessed again after three months.

Brief Negotiated Interview

The intervention group received a Brief Negotiated Interview (BNI) from E.R. personnel, written information about low-risk drinking, and a list of alcohol treatment providers. Patients in the control group received only the handout and referral list.

After three months, the intervention group reported drinking three fewer drinks per week than the control group, and more than one-third of the intervention group reported drinking at low-risk levels, compared with about one-fifth of those in the control group.

"The BNI, a conversation between emergency care providers and patients that involves listening rather than telling, and guiding rather than directing, is designed to review the patient's current drinking patterns, assess their readiness to change, offer advice about the low-risk guidelines and the next steps to pursue, and negotiate a written prescription for change or a drinking agreement with the patient," said co-author Edward Bernstein, M.D., of Boston University School of Medicine.

Brief Intervention Works

To prepare for the study, Dr. Bernstein trained more than 400 emergency department healthcare workers, including physicians, nurses, social workers, nurse practitioners and physician's assistants, how to conduct the 10-minute Brief Negotiated Interviews.

The study confirms previous studies that have shown that screening and brief intervention in primary care and in-patient trauma centers have been effective in reducing harmful drinking patterns, reducing injury rates and reducing costs to society.

The study was published in the December 2007 issue of the Annals of Emergency Medicine.