The effect of computerized tailored brief advice on at-risk drinking in subcritically injured trauma patients

Tim Neumann, Bruno Neuner, Edith Weiss-Gerlach, Hanne Tønnesen, Larry M. Gentilello, Klaus D. Wernecke, Katrin Schmidt, Torsten Schröder, Helmar Wauer, Andreas Heinz, Karl Mann, Joachim M. Müller, Norbert Haas, Wolfgang J. Kox, Claudia D. Spies

Research output: Contribution to journalArticle

119 Scopus citations

Abstract

BACKGROUND: One-third of injured patients treated in the emergency department (ED) have an alcohol use disorder (AUD). Few are screened and receive counseling because ED staff have little time for additional tasks. We hypothesized that computer technology can screen and provide an intervention that reduces at-risk drinking (British Medical Association criteria) in injured ED patients. METHODS: In all, 3,026 subcritically injured patients admitted to an ED were screened for an AUD using a laptop computer that administered the AUD Identification Test (AUDIT) and assessed motivation to reduce drinking. Patients with a positive AUDIT (n = 1,139) were randomized to an intervention (n = 563) or control (n = 576) condition. The computer generated a customized printout based on the patient's own alcohol use pattern, level of motivation, and personal factors, which was provided in the form of feedback and advice. RESULTS: Most patients (85%) used the computer with minimal assistance. At study entry, a similar proportion in each group met criteria for at-risk drinking (49.6% versus 46.8%, p = 0.355). At 6 months, 21.7% of intervention and 30.4% of control patients met criteria for at-risk drinking (p = 0.008). Intervention patients also had a 35.7% decrease in alcohol intake, compared with a 20.5% decrease in controls (p = 0.006). At 12 months, alcohol intake decreased by 22.8% in the intervention group versus 10.9% in controls (p = 0.023), but the proportion of at-risk drinkers did not significantly differ (37.3% versus 42.6%, p = 0.168). CONCLUSIONS: The computer-generated intervention was associated with a significant decrease in alcohol use and at-risk drinking. Research is needed to further evaluate and adapt information technology to provide preventive clinical services in the ED.

Original languageEnglish (US)
Pages (from-to)805-814
Number of pages10
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume61
Issue number4
DOIs
StatePublished - Oct 1 2006

Keywords

  • Alcohol
  • At-risk drinking
  • Computer
  • Emergency
  • Tailored brief advice
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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    Neumann, T., Neuner, B., Weiss-Gerlach, E., Tønnesen, H., Gentilello, L. M., Wernecke, K. D., Schmidt, K., Schröder, T., Wauer, H., Heinz, A., Mann, K., Müller, J. M., Haas, N., Kox, W. J., & Spies, C. D. (2006). The effect of computerized tailored brief advice on at-risk drinking in subcritically injured trauma patients. Journal of Trauma - Injury, Infection and Critical Care, 61(4), 805-814. https://doi.org/10.1097/01.ta.0000196399.29893.52