Annals of Emergency Medicine
Volume 45, Issue 6 , Pages 620-625, June 2005

Emergency Department Brief Motivational Interventions for Alcohol With Motor Vehicle Crash Patients

From the Injury Prevention Center at Rhode Island Hospital (Mello, Nirenberg, Woolard, Becker, Baird); the Department of Emergency Medicine, Rhode Island Hospital (Mello, Woolard, Becker); Brown University (Mello, Nirenberg, Longabaugh, Woolard, Becker, Stein); and DATACORP (Minugh), Providence, RI

Received 10 June 2004; received in revised form 12 October 2004, 16 December 2004 and 11 January 2005; accepted 25 January 2005. published online 28 April 2005.

Study objective

This study compares the effect of a brief motivational intervention for alcohol plus a booster given to emergency department (ED) patients with subcritical injuries from a motor vehicle crash with the effect of brief motivational intervention for alcohol plus a booster in patients treated for non-motor vehicle crash-related injuries.

Methods

A randomized controlled trial (n=539) was conducted at an urban Level I trauma center of brief intervention (1 ED session of brief intervention), brief motivational intervention for alcohol plus a booster (1 ED session plus booster session), or standard care for injured ED patients with an alcohol use problem who were being discharged home. At 12 months, alcohol-related negative consequences and injuries were measured. We performed a secondary analysis comparing motor vehicle crash–injured patients and non–motor vehicle crash–injured patients in the study sample.

Results

Subcritically injured ED patients with harmful or hazardous alcohol use who received brief motivational intervention for alcohol plus a booster had fewer alcohol-related negative consequences and alcohol-related injuries than those receiving brief intervention or standard care at 12-month follow-up (previously reported). A secondary analysis of this result showed that motor vehicle crash patients (n=133) given brief motivational intervention for alcohol plus a booster (n=34) had fewer alcohol-related injuries than those receiving standard care (n=46; P=.001). Moreover, there were no significant differences in alcohol-related injuries among the non–motor vehicle crash–injured patients who received brief intervention or standard care.

Conclusion

Brief motivational intervention for alcohol plus a booster is a useful intervention for subcritically injured ED patients with harmful or hazardous alcohol use. Its effects may be moderated by the cause of injury.

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 Author contributions: This analysis was conceived and designed by MJM, TDN, RL, RW, AM, and JB. It used data previously collected through research funding obtained by RL. AM and JB provided statistical advice. MJM and TDN drafted the manuscript, and all authors contributed substantially to its revisions. MJM takes responsibility for the paper as a whole.Funding and support: Dr. Longabaugh is supported in part by a grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) (R01 AA 09835). Dr. Mello is supported in part by a grant from the CDC (R49 CCR122458). The contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIAAA or CDC.Presented as a poster at the Society for Academic Emergency Medicine annual meeting, May 2004, Orlando, FL, and the Research Society on Alcoholism, June 2004, Vancouver, British Columbia, Canada.

PII: S0196-0644(05)00132-0

doi:10.1016/j.annemergmed.2005.01.026

Annals of Emergency Medicine
Volume 45, Issue 6 , Pages 620-625, June 2005

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