Skip to main content

Brief interventions to prevent excessive alcohol use in adolescents at low-risk presenting to Emergency Departments: Three-arm, randomised trial of effectiveness and cost-effectiveness

Deluca, Paolo, Coulton, Simon, Alam, Mohammed Fasihul, Boniface, Sadie, Cohen, David, Donoghue, Kim, Gilvarry, Eilish, Kaner, Eileen, Maconochie, Ian, McArdle, Paul, and others. (2021) Brief interventions to prevent excessive alcohol use in adolescents at low-risk presenting to Emergency Departments: Three-arm, randomised trial of effectiveness and cost-effectiveness. International Journal of Drug Policy, 93 . Article Number 103113. ISSN 0955-3959. (doi:10.1016/j.drugpo.2021.103113) (KAR id:89366)

Abstract

Background: Alcohol consumption and related harm increase rapidly from the age of 12 years. We evaluated whether alcohol screening and brief intervention is effective and cost-effective in delaying hazardous or harmful drinking amongst low-risk or abstaining adolescents attending Emergency Departments (EDs).

Methods: This ten-centre, three-arm, parallel-group, single-blind, pragmatic, individually randomised trial screened ED attenders aged between 14 and 17 years for alcohol consumption. We sampled at random one third of those scoring at most 2 on AUDIT-C who had access to the internet and, if aged under 16, were Gillick competent or had informed consent from parent or guardian. We randomised them between: screening only (control intervention); one session of face-to-face Personalised Feedback and Brief Advice (PFBA); and PFBA plus an electronic brief intervention (eBI) on smartphone or web. We conducted follow-up after six and 12 months. The principal outcomes were alcohol consumed over the 3 months before 12-month follow up, measured by AUDIT-C; and quality-adjusted life-years.

Findings: Between October 2014 and May 2015, we approached 5,016 eligible patients of whom 3,326 consented to be screened and participate in the trial; 2,571 of these were low-risk drinkers or abstainers, consuming an average 0.14 units per week. We randomised: 304 to screening only; 285 to PFBA; and 294 to PFBA and eBI. We found no significant difference between groups, notably in weekly alcohol consumption: those receiving screening only drank 0.10 units (95% confidence interval 0.05 to 0.18); PFBA 0.12 (0.06 to 0.21); PFBA and eBI 0.10 (0.05 to 0.19).

Interpretation: While drinking levels remained low in this population, this trial found no evidence that PFBA with or without eBI was more effective than screening alone in reducing or delaying alcohol consumption.

Item Type: Article
DOI/Identification number: 10.1016/j.drugpo.2021.103113
Uncontrolled keywords: Adolescent; Alcohol; Alcohol screening; Brief intervention; Cost-effectiveness; Effectiveness; Electronic brief intervention; Emergency department; Low risk; Randomised controlled trial
Subjects: H Social Sciences > H Social Sciences (General)
H Social Sciences > HV Social pathology. Social and public welfare > HV5001 Alcoholism and intemperance
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Depositing User: Edward Skeates
Date Deposited: 19 Jul 2021 12:04 UTC
Last Modified: 15 Nov 2022 12:28 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/89366 (The current URI for this page, for reference purposes)
Coulton, Simon: https://orcid.org/0000-0002-7704-3274
  • Depositors only (login required):

Total unique views for this document in KAR since July 2020. For more details click on the image.