The effectiveness of brief intervention among injured patients with alcohol dependence: who benefits from brief interventions?

Drug Alcohol Depend. 2010 Sep 1;111(1-2):13-20. doi: 10.1016/j.drugalcdep.2009.11.025. Epub 2010 May 20.

Abstract

Background: Research investigating the differential effectiveness of Brief Motivational Interventions (BMIs) among alcohol-dependent and non-dependent patients in the medical setting is limited. Clinical guidelines suggest that BMI is most appropriate for patients with less severe alcohol problems. As a result, most studies evaluating the effectiveness of BMI have excluded patients with an indication of alcohol dependence.

Methods: A randomized controlled trial of brief intervention in the trauma care setting comparing BMI to treatment as usual plus assessment (TAU+) was conducted. Alcohol dependence status was determined for 1336 patients using DSM-IV diagnostic criteria. The differential effectiveness of BMI among alcohol-dependent and non-dependent patients was determined with regard to volume per week, maximum amount consumed, percent days abstinent, alcohol problems at 6 and 12 months follow-up. In addition, the effect of BMI on dependence status at 6 and 12 months was determined.

Results: There was a consistent interaction between BMI and alcohol dependence status, which indicated significantly higher reductions in volume per week at 6 and 12 months follow-up (beta=-.56, p=.03, beta=-.63, p=.02, respectively), maximum amount at 6 months (beta=-.31, p=.04), and significant decreases in percent days abstinent at 12 months (beta=.11, p=.007) and alcohol problems at 12 months (beta=-2.7, p(12)=.04) among patients with alcohol dependence receiving BMI. In addition, patients with alcohol dependence at baseline that received BMI were .59 (95% CI=.39-.91) times less likely to meet criteria for alcohol dependence at six months.

Conclusions: These findings suggest that BMI is more beneficial among patients with alcohol dependence who screen positive for an alcohol-related injury.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcoholism / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motivation
  • Patient Selection
  • Psychotherapy, Brief*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome