Efficacy of Brief Intervention for Heavy Drinking in Hospitalized Patients Questionable

Brief intervention (BI) is being widely advocated for addressing heavy alcohol use among general hospital patients. To determine whether BI improves outcomes for such patients, researchers performed a systematic review of controlled trials. Eleven studies with 2441 participants (men and women age 16+) were identified. Five studies took place on general medical wards, three in trauma centers, two in a variety of settings, and one in an orthopedic/trauma center. Most studies tested one intervention session, two studies involved two sessions, and one study involved three sessions.

• Intervention was associated with self-report of less weekly alcohol consumption in the three studies that examined 6-month outcomes. But, results were mixed and nonsignificant when one of the studies, which tested three sessions and had nonblinded outcome assessments, was excluded.
• No studies found significant differences in consumption between BI patients and controls at 1 year.
• Among the studies presenting change score data on mean alcohol consumption per week, decreases in weekly drinking were greater among BI patients than controls at 12 months (assessed in two studies) but not at 6 months (assessed in two studies).
• No studies found significant differences between BI patients and controls for self-reported alcohol use, laboratory markers, heavy drinking episodes, driving offenses, or death.

Comments by Norma Finkelstein, PhD, LICSW
These findings show mixed results for the efficacy of BI among hospital inpatients who drink heavily. Screening and BI for alcohol use is now widely disseminated in health-care and treatment settings, but it is not yet clear where, when, and with whom BI is effective. Other factors, such as medical history, past hospitalizations, and additional services received may play a role in decreasing consumption. Nevertheless, screening and BI has proven utility in primary-care settings for reducing heavy alcohol use.