The following is a summary of “Effectiveness of a brief intervention for intensive care unit patients with hazardous alcohol use: a randomized controlled trial,” published in the April 2024 issue of Critical Care by Nissilä et al.
Brief interventions (BIs) following hazardous alcohol use screenings are recommended to lessen alcohol-related health harms.
Researchers conducted a retrospective study comparing the effectiveness of BI vs. usual care in ICU survivors having less alcohol consumption with a history of hazardous alcohol use, aiming for at least a 10% reduction.
They employed the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score to assess alcohol history. Adult ICU patients admitted to emergency care in three Finnish university hospitals, with AUDIT-C scores > 5 (women) or > 6 (men), were included. Randomly assigned consenting patients received either a BI or Treatment As Usual (TAU). The BI was provided at ICU discharge or shortly after in the hospital ward. Control patients received TAU. The primary outcome focused on self-reported alcohol consumption in the week before 6 and 12 months post-randomization. Secondary outcomes included changes in AUDIT-C scores at 6 and 12 months from baseline and health-related quality of life and mortality rates. The trial concluded early due to slow recruitment during the pandemic.
The results showed 234 patients, 117 of whom received BI and 117 received TAU. At 6 months, median alcohol intake was 6.5 g (IQR 0–141) in the BI group and 0 g (0–72) in the TAU group (P=0.544). At 12 months, it was 24 g (0–146) and 0 g (0–96) in the BI and TAU groups, respectively (P=0.157). The median change in AUDIT-C from baseline to 6 months was −1 (−4 to 0) in the BI group and 2 (−6 to 0) in the TAU group (P=0.144), and at 12 months, it was −3 (−5 to −1) and −4 (−7 to −1), respectively (P=0.187). At 6 months, 4% (n = 5) of patients with BI and 11% (n = 13) of patients with TAU were abstinent, while at 12 months, it was 10% (n = 12) and 15% (n = 17), respectively. No significant difference in mortality was observed between the groups.
Investigators could not definitively determine the effectiveness of a single BI due to limitations in sample size. Still, a notable portion of participants in both groups did reduce their alcohol intake.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04925-z
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