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• W2300486079 abstract "There is a wealth of evidence on the detrimental impact of excessive alcohol consumption onthe physical, psychological and social health of the population. There also exists a substantialevidence base for the efficacy of brief interventions aimed at reducing alcohol consumptionand related harms across a range of healthcare settings. Research conducted in emergencydepartments has reinforced the current evidence regarding the potential effectiveness andcost-effectiveness. However, the majority of this research has been conducted in singlecentres and there is little evidence of the wider issues of generalisability and implementationof brief interventions across emergency departments. The study design is a prospectivepragmatic factorial cluster randomised controlled trial. Emergency Departments (ED) (n = 9)were randomised to a combination of screening tool (M-SASQ vs. FAST vs. SIPS-PAT) andan intervention (Minimal intervention-PIL vs. Brief advice-BA vs. Brief lifestyle counseling-BLC). The primary hypothesis was that BLC delivered by an Alcohol Health Worker (AHW)was more effective than BA or PIL delivered by ED staff. Secondary hypotheses looked atwhether short screening instruments were more acceptable and as efficient as longerscreening instruments and the cost-effectiveness of SBI in ED. Participants were followed upat 6 and 12 months. The data analysis has shown a significantly higher positive attitude andmotivation (p < .001) of the 250 A&E staff involved in the trial (SAAPPQ) compared with stafffrom primary care and probation settings. This positive attitude also improved after training(p < .001). However, SBI implementation was difficult and in some settings needed externalsupport. The main implementation issues, challenges and solutions will be explored. Overall,a total of 5992 individuals were approached and 3696 were eligible and screened with 1491screening positive. The initial results indicate a relative high prevalence of alcohol usedisorders in this population (40.3%), which varies considerably across EDs (23.8–71.3%).Mean age was 40 years and the majority were male (59.2%). In terms of screening tools, thescreen conversion rate was significantly higher for M-SASQ versus FAST and PAT andsignificantly higher for M-SASQ versus FAST. Adjusting the analysis using multi-levelmodeling to account for potential clustering effects indicated that M-SASQ was significantlybetter than PAT at identifying hazardous alcohol users." @default.
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• W2300486079 date "2010-06-01" @default.
• W2300486079 modified "2023-09-22" @default.
• W2300486079 title "Challenges and solutions in implementing screening and brief interventions for hazardous alcohol use in accident and emergency departments." @default.
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