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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

Paolo Deluca, Simon Coulton, Mohammed Fasihul Alam, Sadie Boniface, David Cohen, Kim Donoghue, Eilish Gilvarry, Eileen Kaner, Ian Maconochie, Paul McArdle, Ruth McGovern, Dorothy Newbury-Birch, Robert Patton, Tracy Pellatt-Higgins, Ceri Phillips, Thomas Phillips, Rhys Pockett Orcid Logo, Ian Russell Orcid Logo, John Strang, Colin Drummond

International Journal of Drug Policy, Volume: 93, Start page: 103113

Swansea University Authors: Ceri Phillips, Rhys Pockett Orcid Logo, Ian Russell Orcid Logo

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DOI (Published version): 10.1016/j.drugpo.2021.103113

Abstract

BackgroundAlcohol 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...

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Published in: International Journal of Drug Policy
ISSN: 0955-3959
Published: Elsevier BV 2021
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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).MethodsThis 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.FindingsBetween 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).InterpretationWhile 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.</abstract><type>Journal Article</type><journal>International Journal of Drug Policy</journal><volume>93</volume><journalNumber/><paginationStart>103113</paginationStart><paginationEnd/><publisher>Elsevier BV</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0955-3959</issnPrint><issnElectronic/><keywords>Alcohol; Alcohol screening; Brief intervention; Electronic brief intervention; Adolescent; Low risk; Emergency department; Randomised controlled trial; Effectiveness; Cost-effectiveness</keywords><publishedDay>1</publishedDay><publishedMonth>7</publishedMonth><publishedYear>2021</publishedYear><publishedDate>2021-07-01</publishedDate><doi>10.1016/j.drugpo.2021.103113</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm/><funders>NIHR</funders><lastEdited>2021-11-19T03:38:25.4111255</lastEdited><Created>2021-01-22T11:36:59.2312618</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care</level></path><authors><author><firstname>Paolo</firstname><surname>Deluca</surname><order>1</order></author><author><firstname>Simon</firstname><surname>Coulton</surname><order>2</order></author><author><firstname>Mohammed Fasihul</firstname><surname>Alam</surname><order>3</order></author><author><firstname>Sadie</firstname><surname>Boniface</surname><order>4</order></author><author><firstname>David</firstname><surname>Cohen</surname><order>5</order></author><author><firstname>Kim</firstname><surname>Donoghue</surname><order>6</order></author><author><firstname>Eilish</firstname><surname>Gilvarry</surname><order>7</order></author><author><firstname>Eileen</firstname><surname>Kaner</surname><order>8</order></author><author><firstname>Ian</firstname><surname>Maconochie</surname><order>9</order></author><author><firstname>Paul</firstname><surname>McArdle</surname><order>10</order></author><author><firstname>Ruth</firstname><surname>McGovern</surname><order>11</order></author><author><firstname>Dorothy</firstname><surname>Newbury-Birch</surname><order>12</order></author><author><firstname>Robert</firstname><surname>Patton</surname><order>13</order></author><author><firstname>Tracy</firstname><surname>Pellatt-Higgins</surname><order>14</order></author><author><firstname>Ceri</firstname><surname>Phillips</surname><order>15</order></author><author><firstname>Thomas</firstname><surname>Phillips</surname><order>16</order></author><author><firstname>Rhys</firstname><surname>Pockett</surname><orcid>0000-0003-4135-7383</orcid><order>17</order></author><author><firstname>Ian</firstname><surname>Russell</surname><orcid>0000-0002-0069-479X</orcid><order>18</order></author><author><firstname>John</firstname><surname>Strang</surname><order>19</order></author><author><firstname>Colin</firstname><surname>Drummond</surname><order>20</order></author></authors><documents><document><filename>56102__20594__c81445894d034de1ab30e0bc672a924e.pdf</filename><originalFilename>56102.pdf</originalFilename><uploaded>2021-08-09T17:02:30.3693630</uploaded><type>Output</type><contentLength>1183530</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2021 The Authors. 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spelling 2021-11-19T03:38:25.4111255 v2 56102 2021-01-22 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 932c7a406ab4b6e4a881d422ca03c289 Ceri Phillips Ceri Phillips true false 8a3882ebcc6a8fb3b2c13fc2ff716bf2 0000-0003-4135-7383 Rhys Pockett Rhys Pockett true false 07f8ce1304fdfe94981330301c2b3977 0000-0002-0069-479X Ian Russell Ian Russell true false 2021-01-22 FGMHL BackgroundAlcohol 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).MethodsThis 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.FindingsBetween 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).InterpretationWhile 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. Journal Article International Journal of Drug Policy 93 103113 Elsevier BV 0955-3959 Alcohol; Alcohol screening; Brief intervention; Electronic brief intervention; Adolescent; Low risk; Emergency department; Randomised controlled trial; Effectiveness; Cost-effectiveness 1 7 2021 2021-07-01 10.1016/j.drugpo.2021.103113 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University NIHR 2021-11-19T03:38:25.4111255 2021-01-22T11:36:59.2312618 Faculty of Medicine, Health and Life Sciences School of Health and Social Care Paolo Deluca 1 Simon Coulton 2 Mohammed Fasihul Alam 3 Sadie Boniface 4 David Cohen 5 Kim Donoghue 6 Eilish Gilvarry 7 Eileen Kaner 8 Ian Maconochie 9 Paul McArdle 10 Ruth McGovern 11 Dorothy Newbury-Birch 12 Robert Patton 13 Tracy Pellatt-Higgins 14 Ceri Phillips 15 Thomas Phillips 16 Rhys Pockett 0000-0003-4135-7383 17 Ian Russell 0000-0002-0069-479X 18 John Strang 19 Colin Drummond 20 56102__20594__c81445894d034de1ab30e0bc672a924e.pdf 56102.pdf 2021-08-09T17:02:30.3693630 Output 1183530 application/pdf Version of Record true © 2021 The Authors. This is an open access article under the CC BY-NC-ND license true eng http://creativecommons.org/licenses/by-nc-nd/4.0/
title 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
spellingShingle 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
Ceri Phillips
Rhys Pockett
Ian Russell
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
author_id_str_mv 932c7a406ab4b6e4a881d422ca03c289
8a3882ebcc6a8fb3b2c13fc2ff716bf2
07f8ce1304fdfe94981330301c2b3977
author_id_fullname_str_mv 932c7a406ab4b6e4a881d422ca03c289_***_Ceri Phillips
8a3882ebcc6a8fb3b2c13fc2ff716bf2_***_Rhys Pockett
07f8ce1304fdfe94981330301c2b3977_***_Ian Russell
author Ceri Phillips
Rhys Pockett
Ian Russell
author2 Paolo Deluca
Simon Coulton
Mohammed Fasihul Alam
Sadie Boniface
David Cohen
Kim Donoghue
Eilish Gilvarry
Eileen Kaner
Ian Maconochie
Paul McArdle
Ruth McGovern
Dorothy Newbury-Birch
Robert Patton
Tracy Pellatt-Higgins
Ceri Phillips
Thomas Phillips
Rhys Pockett
Ian Russell
John Strang
Colin Drummond
format Journal article
container_title International Journal of Drug Policy
container_volume 93
container_start_page 103113
publishDate 2021
institution Swansea University
issn 0955-3959
doi_str_mv 10.1016/j.drugpo.2021.103113
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care
document_store_str 1
active_str 0
description BackgroundAlcohol 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).MethodsThis 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.FindingsBetween 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).InterpretationWhile 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.
published_date 2021-07-01T04:10:48Z
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