A Multisite Randomized Controlled Trial of Brief Intervention to Reduce Drinking in the Trauma Care Setting: How Brief Is Brief?

Objective:Determine the efficacy of 3 brief intervention strategies that address heavy drinking among injured patients. Background:The content or structure of brief interventions most effective at reducing alcohol misuse after traumatic injury is not known. Methods:Injured patients from 3 trauma centers were screened for heavy drinking and randomly assigned to brief advice (n = 200), brief motivational intervention (BMI) (n = 203), or BMI plus a telephone booster using personalized feedback or BMI + B (n = 193). Among those randomly assigned, 57% met criteria for moderate to severe alcohol problems. The primary drinking outcomes were assessed at 3, 6, and 12 months. Results:Compared with brief advice and BMI, BMI + B showed significant reductions in the number of standard drinks consumed per week at 3 (&Dgr; adjusted means: −1.22, 95% confidence interval [CI]: −0.99, approximately −1.49, P = 0.01) and 6 months (&Dgr; adjusted means: −1.42, 95% CI: −1.14, approximately −1.76, P = 0.02), percent days of heavy drinking at 6 months (&Dgr; adjusted means: −5.90, 95% CI: −11.40, approximately −0.40, P = 0.04), maximum number of standard drinks consumed in 1 day at 3 (&Dgr; adjusted means: −1.38, 95% CI: −1.18, approximately −1.62, P = 0.003) and 12 months (&Dgr; adjusted means: −1.71, 95% CI: −1.47, approximately −1.99, P = 0.02), and number of standard drinks consumed per drinking day at 3 (&Dgr; adjusted means: −1.49, 95% CI: −1.35, approximately −1.65, P = 0.002) and 6 months (&Dgr; adjusted means: −1.28, 95% CI: −1.17, approximately −1.40, P = 0.01). Conclusions:Brief interventions based on motivational interviewing with a telephone booster using personalized feedback were most effective at achieving reductions in alcohol intake across the 3 trauma centers.