TY - JOUR
T1 - The effectiveness of a brief intervention for intensive care unit patients with hazardous alcohol use
T2 - a randomized controlled trial
AU - Nissilä, Eliisa
AU - Hynninen, Marja
AU - Jalkanen, Ville
AU - Kuitunen, Anne
AU - Bäcklund, Minna
AU - Inkinen, Outi
AU - Hästbacka, Johanna
N1 - Publisher Copyright:
© The Author(s) 2024.
PY - 2024/12
Y1 - 2024/12
N2 - Background: Screening for hazardous alcohol use and performing brief interventions (BIs) are recommended to reduce alcohol-related negative health consequences. We aimed to compare the effectiveness (defined as an at least 10% absolute difference) of BI with usual care in reducing alcohol intake in intensive care unit survivors with history of hazardous alcohol use. Methods: We used Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score to assess history of alcohol use. Patients: Emergency admitted adult ICU patients in three Finnish university hospitals, with an AUDIT-C score > 5 (women), or > 6 (men). We randomized consenting eligible patients to receive a BI or treatment as usual (TAU). Intervention: BI was delivered by the time of ICU discharge or shortly thereafter in the hospital ward. Controls: Control patients received TAU. Outcome: The primary outcome was self-reported alcohol consumption during the preceding week 6 and 12 months after randomization. Secondary outcomes were the change in AUDIT-C scores from baseline to 6 and 12 months, health-related quality of life, and mortality. The trial was terminated early due to slow recruitment during the pandemic. Results: We randomized 234 patients to receive BI (N = 117) or TAU (N = 117). At 6 months, the median alcohol intake in the BI and TAU groups were 6.5 g (interquartile range [IQR] 0–141) and 0 g (0–72), respectively (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). Median change in AUDIT-C from baseline to 6 months was − 1 (− 4 to 0) and 2 (− 6 to 0), (p = 0.144) in the BI and TAU groups, and to 12 months − 3 (− 5 to − 1) and − 4 (− 7 to − 1), respectively (p = 0.187). In total, 4% (n = 5) of patients in the BI group and 11% (n = 13) of patients in the TAU group were abstinent at 6 months, and 10% (n = 12) and 15% (n = 17), respectively, at 12 months. No between-groups difference in mortality emerged. Conclusion: As underpowered, our study cannot reject or confirm the hypothesis that a single BI early after critical illness is effective in reducing the amount of alcohol consumed compared to TAU. However, a considerable number in both groups reduced their alcohol consumption. Trial registration: ClinicalTrials.gov (NCT03047577).
AB - Background: Screening for hazardous alcohol use and performing brief interventions (BIs) are recommended to reduce alcohol-related negative health consequences. We aimed to compare the effectiveness (defined as an at least 10% absolute difference) of BI with usual care in reducing alcohol intake in intensive care unit survivors with history of hazardous alcohol use. Methods: We used Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score to assess history of alcohol use. Patients: Emergency admitted adult ICU patients in three Finnish university hospitals, with an AUDIT-C score > 5 (women), or > 6 (men). We randomized consenting eligible patients to receive a BI or treatment as usual (TAU). Intervention: BI was delivered by the time of ICU discharge or shortly thereafter in the hospital ward. Controls: Control patients received TAU. Outcome: The primary outcome was self-reported alcohol consumption during the preceding week 6 and 12 months after randomization. Secondary outcomes were the change in AUDIT-C scores from baseline to 6 and 12 months, health-related quality of life, and mortality. The trial was terminated early due to slow recruitment during the pandemic. Results: We randomized 234 patients to receive BI (N = 117) or TAU (N = 117). At 6 months, the median alcohol intake in the BI and TAU groups were 6.5 g (interquartile range [IQR] 0–141) and 0 g (0–72), respectively (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). Median change in AUDIT-C from baseline to 6 months was − 1 (− 4 to 0) and 2 (− 6 to 0), (p = 0.144) in the BI and TAU groups, and to 12 months − 3 (− 5 to − 1) and − 4 (− 7 to − 1), respectively (p = 0.187). In total, 4% (n = 5) of patients in the BI group and 11% (n = 13) of patients in the TAU group were abstinent at 6 months, and 10% (n = 12) and 15% (n = 17), respectively, at 12 months. No between-groups difference in mortality emerged. Conclusion: As underpowered, our study cannot reject or confirm the hypothesis that a single BI early after critical illness is effective in reducing the amount of alcohol consumed compared to TAU. However, a considerable number in both groups reduced their alcohol consumption. Trial registration: ClinicalTrials.gov (NCT03047577).
KW - AUDIT-C
KW - Brief intervention
KW - Critical care
KW - Hazardous alcohol consumption
KW - Intensive care unit
KW - Mortality
KW - RCT
KW - 3126 Surgery, anesthesiology, intensive care, radiology
U2 - 10.1186/s13054-024-04925-z
DO - 10.1186/s13054-024-04925-z
M3 - Article
C2 - 38689346
AN - SCOPUS:85191861732
SN - 1364-8535
VL - 28
JO - Critical Care
JF - Critical Care
IS - 1
M1 - 145
ER -