COUNTRY: UNITED STATES
Implementer: University of New Mexico Hospital
Partners: National Institute on Alcohol Abuse and Alcoholism; General Clinical Research Center, University of New Mexico
Program Overview: Patients involved in motor vehicle crashes (MVCs) and admitted to hospital for at least 24 hours, who have a BAC of at least 0.8 mg/mL or AUDIT score of at least 8,receive a brief intervention (BI) about alcohol use.
Program Design: The BI consists of a 30-minute discussion in the style of motivational interviewing with either a social worker or a trauma surgeon. The conversation consists of a non-confrontational, patient-centered discussion that allows the participant to talk about how alcohol use has affected his or her life.
-The patient’s good and bad perceptions of drinking and the motivation and confidence to change drinking behaviors are usually used to open the discussion.
-There is no attempt to discuss reasons why the participants drink problematically and no prescription from the interventionist to change drinking in a particular way. Instead, the interventionist uses reflective listening and empathy to direct the flow of the conversation and to emphasize items that pulled toward positive talk about change. The responsibility to change is left to the participant, and the interventionist uses the participant’s experiences to boost self-efficacy to make a change.
Evaluation: A prospective, randomized clinical trial randomly allocated patients (n=126) involved in MVCs to receive standard care (SC) or a BI about their alcohol use.
-SC consisted of providing the participants with a list of telephone numbers with alcohol treatment organizations near their homes.
The primary outcome measure for this analysis was driving under the influence (DUI) arrest within 3 years of hospital discharge.
Key findings: Patients who received a BI during trauma center admission were less likely to be arrested for DUI within 3 years of discharge. BI was the strongest protective factor against DUI arrest; lower prior number of DUIs and older age were also associated with lower likelihood of DUI arrest.
-21.9% of participants in the SC group had a DUI arrest within 3 years of hospital discharge compared to 11.3% in the BI group.
-This study demonstrates that talking to patients in a non-confrontational way about their alcohol use while they are admitted for an injury has an impact on the likelihood of subsequent DUI arrest.
Schermer, C.R., Moyers, T.B., Miller, W.R., Bloomfield, L.A. (2006). Trauma center brief interventions for alcohol disorders decrease subsequent driving under the influence arrests. The Journal of Trauma, 60(1), 29-34.
Target Audience: Drink driving offenders
Issues: Drinking and Driving
Setting: Primary health care settings
Approach: Motivational Interviewing, Motivation Enhancement