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Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic rand...

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

Addiction, Volume: 117, Issue: 8, Pages: 2200 - 2214

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

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DOI (Published version): 10.1111/add.15884

Abstract

Background and aimsAlcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost-effectiveness of ASBI compared with screening al...

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Published in: Addiction
ISSN: 0965-2140 1360-0443
Published: Wiley 2022
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2022-07-25T11:39:33.4444981</datestamp><bib-version>v2</bib-version><id>59564</id><entry>2022-03-09</entry><title>Effectiveness and cost&#x2010;effectiveness of face&#x2010;to&#x2010;face and electronic brief interventions versus screening alone to reduce alcohol consumption among high&#x2010;risk adolescents presenting to emergency departments: three&#x2010;arm pragmatic randomized trial (SIPS Junior high risk trial)</title><swanseaauthors><author><sid>932c7a406ab4b6e4a881d422ca03c289</sid><firstname>Ceri</firstname><surname>Phillips</surname><name>Ceri Phillips</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>8a3882ebcc6a8fb3b2c13fc2ff716bf2</sid><ORCID>0000-0003-4135-7383</ORCID><firstname>Rhys</firstname><surname>Pockett</surname><name>Rhys Pockett</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>07f8ce1304fdfe94981330301c2b3977</sid><ORCID>0000-0002-0069-479X</ORCID><firstname>Ian</firstname><surname>Russell</surname><name>Ian Russell</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2022-03-09</date><deptcode>FGMHL</deptcode><abstract>Background and aimsAlcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost-effectiveness of ASBI compared with screening alone (SA) in high-risk adolescents.Design, Setting and ParticipantsMulti-centre, three-group, single-blind, individually randomized trial with follow-ups after 6 and 12&#x2009;months in 10 ED settings in England. From October 2014 to May 2015 we screened 3327 adolescents aged 14 to 18&#x2009;years, of whom 756 (22.7%) scored at least 3 on the Alcohol Use Disorders Identification Test: consumption (AUDIT-C) and consented to participate in this trial. Mean age was 16.1 years; 50.2% were female and 84.9% were white.InterventionsInterventions were personalized feedback and brief advice (PFBA), personalized feedback plus electronic brief intervention (eBI) and SA.MeasuresThe primary outcome was the weekly alcohol consumed in standard UK units (8 g ethanol) at 12&#x2009;months post-randomization, derived from extended AUDIT-C. Economic outcomes included quality of life and service use, from perspectives of both the National Health Service and personal social services (NHS&amp;PSS) and society.FindingsAt 12&#x2009;months, mean weekly consumption was 2.99 [95% confidence interval (CI)&#x2009;= 2.38&#x2013;3.70] standard units for the SA group, 3.56 (95% CI&#x2009;=&#x2009;2.90, 4.32) for PFBA and 3.18 (95% CI&#x2009;=&#x2009;2.50, 3.97) for eBI, showing no significant differences. The PFBA group consumed mean 0.57 (&#x2212;0.36, 1.70) units more than SA; and eBIs consumed 0.19 (&#x2212;0.71, 1.30) more. Bayes factors suggested lack of effectiveness explained non-significance. From the NHS&amp;PSS perspective, economic analysis showed that PFBA and eBI were not cost-effective compared with SA: PFBA yielded incremental cost-effectiveness ratio of &#xA3;6213 (&#x2212;&#xA3;736&#x2009;843, &#xA3;812&#x2009;884), with the intervention having 54% probability of being cost-effective compared with SA at the &#xA3;20&#x2009;000 WTP threshold.ConclusionsIn emergency departments in England, neither personalized feedback and brief advice nor personalized feedback plus electronic brief intervention showed evidence of being effective or cost-effective when compared with screening alone in reducing alcohol consumption among adolescents.</abstract><type>Journal Article</type><journal>Addiction</journal><volume>117</volume><journalNumber>8</journalNumber><paginationStart>2200</paginationStart><paginationEnd>2214</paginationEnd><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0965-2140</issnPrint><issnElectronic>1360-0443</issnElectronic><keywords>Alcohol, Alcohol screening, Adolescent, High risk, Brief intervention, Electronic brief intervention, Emergency Department, Pragmatic randomised trial, Effectiveness, Cost-effectiveness</keywords><publishedDay>1</publishedDay><publishedMonth>8</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-08-01</publishedDate><doi>10.1111/add.15884</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>External research funder(s) paid the OA fee (includes OA grants disbursed by the Library)</apcterm><funders>National Institute for Health Research (NIHR) Programme Grant for Applied Research, Grant/Award Number: RP-PG-0609-10162</funders><projectreference/><lastEdited>2022-07-25T11:39:33.4444981</lastEdited><Created>2022-03-09T14:42:31.6419482</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><orcid>0000-0002-9511-7230</orcid><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><orcid>0000-0003-3492-6402</orcid><order>4</order></author><author><firstname>Kim</firstname><surname>Donoghue</surname><orcid>0000-0002-7316-1716</orcid><order>5</order></author><author><firstname>Eilish</firstname><surname>Gilvarry</surname><order>6</order></author><author><firstname>Eileen</firstname><surname>Kaner</surname><order>7</order></author><author><firstname>Ellen</firstname><surname>Lynch</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&#x2010;Birch</surname><order>12</order></author><author><firstname>Robert</firstname><surname>Patton</surname><order>13</order></author><author><firstname>Tracy</firstname><surname>Pellat&#x2010;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><orcid>0000-0002-5413-2725</orcid><order>19</order></author><author><firstname>Colin</firstname><surname>Drummond</surname><order>20</order></author></authors><documents><document><filename>59564__24264__c33b1637d6274ad29115f86c3a4d0b7d.pdf</filename><originalFilename>59564.pdf</originalFilename><uploaded>2022-06-09T13:56:22.3779413</uploaded><type>Output</type><contentLength>1732075</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2022-07-25T11:39:33.4444981 v2 59564 2022-03-09 Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) 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 2022-03-09 FGMHL Background and aimsAlcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost-effectiveness of ASBI compared with screening alone (SA) in high-risk adolescents.Design, Setting and ParticipantsMulti-centre, three-group, single-blind, individually randomized trial with follow-ups after 6 and 12 months in 10 ED settings in England. From October 2014 to May 2015 we screened 3327 adolescents aged 14 to 18 years, of whom 756 (22.7%) scored at least 3 on the Alcohol Use Disorders Identification Test: consumption (AUDIT-C) and consented to participate in this trial. Mean age was 16.1 years; 50.2% were female and 84.9% were white.InterventionsInterventions were personalized feedback and brief advice (PFBA), personalized feedback plus electronic brief intervention (eBI) and SA.MeasuresThe primary outcome was the weekly alcohol consumed in standard UK units (8 g ethanol) at 12 months post-randomization, derived from extended AUDIT-C. Economic outcomes included quality of life and service use, from perspectives of both the National Health Service and personal social services (NHS&PSS) and society.FindingsAt 12 months, mean weekly consumption was 2.99 [95% confidence interval (CI) = 2.38–3.70] standard units for the SA group, 3.56 (95% CI = 2.90, 4.32) for PFBA and 3.18 (95% CI = 2.50, 3.97) for eBI, showing no significant differences. The PFBA group consumed mean 0.57 (−0.36, 1.70) units more than SA; and eBIs consumed 0.19 (−0.71, 1.30) more. Bayes factors suggested lack of effectiveness explained non-significance. From the NHS&PSS perspective, economic analysis showed that PFBA and eBI were not cost-effective compared with SA: PFBA yielded incremental cost-effectiveness ratio of £6213 (−£736 843, £812 884), with the intervention having 54% probability of being cost-effective compared with SA at the £20 000 WTP threshold.ConclusionsIn emergency departments in England, neither personalized feedback and brief advice nor personalized feedback plus electronic brief intervention showed evidence of being effective or cost-effective when compared with screening alone in reducing alcohol consumption among adolescents. Journal Article Addiction 117 8 2200 2214 Wiley 0965-2140 1360-0443 Alcohol, Alcohol screening, Adolescent, High risk, Brief intervention, Electronic brief intervention, Emergency Department, Pragmatic randomised trial, Effectiveness, Cost-effectiveness 1 8 2022 2022-08-01 10.1111/add.15884 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University External research funder(s) paid the OA fee (includes OA grants disbursed by the Library) National Institute for Health Research (NIHR) Programme Grant for Applied Research, Grant/Award Number: RP-PG-0609-10162 2022-07-25T11:39:33.4444981 2022-03-09T14:42:31.6419482 Faculty of Medicine, Health and Life Sciences School of Health and Social Care Paolo Deluca 0000-0002-9511-7230 1 Simon Coulton 2 Mohammed Fasihul Alam 3 Sadie Boniface 0000-0003-3492-6402 4 Kim Donoghue 0000-0002-7316-1716 5 Eilish Gilvarry 6 Eileen Kaner 7 Ellen Lynch 8 Ian Maconochie 9 Paul McArdle 10 Ruth McGovern 11 Dorothy Newbury‐Birch 12 Robert Patton 13 Tracy Pellat‐Higgins 14 Ceri Phillips 15 Thomas Phillips 16 Rhys Pockett 0000-0003-4135-7383 17 Ian Russell 0000-0002-0069-479X 18 John Strang 0000-0002-5413-2725 19 Colin Drummond 20 59564__24264__c33b1637d6274ad29115f86c3a4d0b7d.pdf 59564.pdf 2022-06-09T13:56:22.3779413 Output 1732075 application/pdf Version of Record true © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License true eng http://creativecommons.org/licenses/by/4.0/
title Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial)
spellingShingle Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial)
Ceri Phillips
Rhys Pockett
Ian Russell
title_short Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial)
title_full Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial)
title_fullStr Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial)
title_full_unstemmed Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial)
title_sort Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial)
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
Kim Donoghue
Eilish Gilvarry
Eileen Kaner
Ellen Lynch
Ian Maconochie
Paul McArdle
Ruth McGovern
Dorothy Newbury‐Birch
Robert Patton
Tracy Pellat‐Higgins
Ceri Phillips
Thomas Phillips
Rhys Pockett
Ian Russell
John Strang
Colin Drummond
format Journal article
container_title Addiction
container_volume 117
container_issue 8
container_start_page 2200
publishDate 2022
institution Swansea University
issn 0965-2140
1360-0443
doi_str_mv 10.1111/add.15884
publisher Wiley
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 Background and aimsAlcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost-effectiveness of ASBI compared with screening alone (SA) in high-risk adolescents.Design, Setting and ParticipantsMulti-centre, three-group, single-blind, individually randomized trial with follow-ups after 6 and 12 months in 10 ED settings in England. From October 2014 to May 2015 we screened 3327 adolescents aged 14 to 18 years, of whom 756 (22.7%) scored at least 3 on the Alcohol Use Disorders Identification Test: consumption (AUDIT-C) and consented to participate in this trial. Mean age was 16.1 years; 50.2% were female and 84.9% were white.InterventionsInterventions were personalized feedback and brief advice (PFBA), personalized feedback plus electronic brief intervention (eBI) and SA.MeasuresThe primary outcome was the weekly alcohol consumed in standard UK units (8 g ethanol) at 12 months post-randomization, derived from extended AUDIT-C. Economic outcomes included quality of life and service use, from perspectives of both the National Health Service and personal social services (NHS&PSS) and society.FindingsAt 12 months, mean weekly consumption was 2.99 [95% confidence interval (CI) = 2.38–3.70] standard units for the SA group, 3.56 (95% CI = 2.90, 4.32) for PFBA and 3.18 (95% CI = 2.50, 3.97) for eBI, showing no significant differences. The PFBA group consumed mean 0.57 (−0.36, 1.70) units more than SA; and eBIs consumed 0.19 (−0.71, 1.30) more. Bayes factors suggested lack of effectiveness explained non-significance. From the NHS&PSS perspective, economic analysis showed that PFBA and eBI were not cost-effective compared with SA: PFBA yielded incremental cost-effectiveness ratio of £6213 (−£736 843, £812 884), with the intervention having 54% probability of being cost-effective compared with SA at the £20 000 WTP threshold.ConclusionsIn emergency departments in England, neither personalized feedback and brief advice nor personalized feedback plus electronic brief intervention showed evidence of being effective or cost-effective when compared with screening alone in reducing alcohol consumption among adolescents.
published_date 2022-08-01T04:16:59Z
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score 11.013148

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