Brief alcohol intervention in alcohol involved facial fracture patients-a survey of patient attitudes to screening and intervention

Oral Maxillofac Surg. 2017 Jun;21(2):219-226. doi: 10.1007/s10006-017-0621-6. Epub 2017 Mar 28.

Abstract

Purpose: Alcohol intoxication is an important contributor to traumatic facial injuries. The period following injuries afford clinicians a useful window of opportunity to provide alcohol screening and brief intervention (SBI) which may affect changes in patients' future drinking behaviour. Although SBI has been reported to decrease at risk drinking and potentially trauma recurrence, it is not routinely utilised in most clinical settings in the world. This study aims to assess utilisation of, as well as patients' knowledge and attitude towards SBI in the management of patients presenting with alcohol-related facial fractures.

Methods: Twenty consecutive patients who presented to Western Health with facial fractures who met selection criteria were offered an alcohol screening and survey questionnaire.

Results: Ninety percent of patients were male and 50% were aged between 19 and 34. ASSIST score showed 65% were in the moderate risk category; 75% reported this was their first admission with alcohol related trauma. Although 75% acknowledged alcohol as a main cause of injury, only 40% agreed they drink too much. Forty-four percent felt that talking to a healthcare worker might help and 33% would consider accepting help. Forty-seven percent felt reading materials would be helpful in changing future drinking habits. Whilst 63% would like to know safe drinking limit, only 45% would like to have a discussion about alcohol-related harms.

Conclusions: Most patients presented in this survey were in moderate risk category who are amenable to behavioural change with provision of SBI. However, there is resistance to implementation of this intervention due to lack of knowledge, self-awareness and willingness to change. Nonetheless, patients are prepared to accept advice from clinicians and some formats of intervention. It is important to formulate a simple screening questionnaire and intervention strategy that are easy to administer to affect positive changes in patients with harmful drinking behaviours.

Keywords: Fracture; Intervention; Maxillofacial; Screening.

MeSH terms

  • Adult
  • Alcoholic Intoxication / complications*
  • Alcoholic Intoxication / rehabilitation*
  • Female
  • Humans
  • Male
  • Mass Screening*
  • Maxillofacial Injuries / etiology*
  • Maxillofacial Injuries / rehabilitation*
  • Patient Acceptance of Health Care
  • Psychotherapy, Brief*
  • Referral and Consultation
  • Surveys and Questionnaires
  • Young Adult