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Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial)
BACKGROUND AND AIMS: Alcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost‐effectiveness of ASBI compared with screening...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9540754/ https://www.ncbi.nlm.nih.gov/pubmed/35315170 http://dx.doi.org/10.1111/add.15884 |
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author | Deluca, Paolo Coulton, Simon Alam, Mohammed Fasihul Boniface, Sadie Donoghue, Kim Gilvarry, Eilish Kaner, Eileen Lynch, Ellen Maconochie, Ian McArdle, Paul McGovern, Ruth Newbury‐Birch, Dorothy Patton, Robert Pellat‐Higgins, Tracy Phillips, Ceri Phillips, Thomas Pockett, Rhys D. Russell, Ian T. Strang, John Drummond, Colin |
author_facet | Deluca, Paolo Coulton, Simon Alam, Mohammed Fasihul Boniface, Sadie Donoghue, Kim Gilvarry, Eilish Kaner, Eileen Lynch, Ellen Maconochie, Ian McArdle, Paul McGovern, Ruth Newbury‐Birch, Dorothy Patton, Robert Pellat‐Higgins, Tracy Phillips, Ceri Phillips, Thomas Pockett, Rhys D. Russell, Ian T. Strang, John Drummond, Colin |
author_sort | Deluca, Paolo |
collection | PubMed |
description | BACKGROUND AND AIMS: Alcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost‐effectiveness of ASBI compared with screening alone (SA) in high‐risk adolescents. DESIGN, SETTING AND PARTICIPANTS: Multi‐centre, three‐group, single‐blind, individually randomized trial with follow‐ups after 6 and 12 months in 10 ED settings in England. From October 2014 to May 2015 we screened 3327 adolescents aged 14 to 18 years, of whom 756 (22.7%) scored at least 3 on the Alcohol Use Disorders Identification Test: consumption (AUDIT‐C) and consented to participate in this trial. Mean age was 16.1 years; 50.2% were female and 84.9% were white. INTERVENTIONS: Interventions were personalized feedback and brief advice (PFBA), personalized feedback plus electronic brief intervention (eBI) and SA. MEASURES: The primary outcome was the weekly alcohol consumed in standard UK units (8 g ethanol) at 12 months post‐randomization, derived from extended AUDIT‐C. Economic outcomes included quality of life and service use, from perspectives of both the National Health Service and personal social services (NHS&PSS) and society. FINDINGS: At 12 months, mean weekly consumption was 2.99 [95% confidence interval (CI) = 2.38–3.70] standard units for the SA group, 3.56 (95% CI = 2.90, 4.32) for PFBA and 3.18 (95% CI = 2.50, 3.97) for eBI, showing no significant differences. The PFBA group consumed mean 0.57 (−0.36, 1.70) units more than SA; and eBIs consumed 0.19 (−0.71, 1.30) more. Bayes factors suggested lack of effectiveness explained non‐significance. From the NHS&PSS perspective, economic analysis showed that PFBA and eBI were not cost‐effective compared with SA: PFBA yielded incremental cost‐effectiveness ratio of £6213 (−£736 843, £812 884), with the intervention having 54% probability of being cost‐effective compared with SA at the £20 000 WTP threshold. CONCLUSIONS: In emergency departments in England, neither personalized feedback and brief advice nor personalized feedback plus electronic brief intervention showed evidence of being effective or cost‐effective when compared with screening alone in reducing alcohol consumption among adolescents. |
format | Online Article Text |
id | pubmed-9540754 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95407542022-10-14 Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) Deluca, Paolo Coulton, Simon Alam, Mohammed Fasihul Boniface, Sadie Donoghue, Kim Gilvarry, Eilish Kaner, Eileen Lynch, Ellen Maconochie, Ian McArdle, Paul McGovern, Ruth Newbury‐Birch, Dorothy Patton, Robert Pellat‐Higgins, Tracy Phillips, Ceri Phillips, Thomas Pockett, Rhys D. Russell, Ian T. Strang, John Drummond, Colin Addiction Research Reports BACKGROUND AND AIMS: Alcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost‐effectiveness of ASBI compared with screening alone (SA) in high‐risk adolescents. DESIGN, SETTING AND PARTICIPANTS: Multi‐centre, three‐group, single‐blind, individually randomized trial with follow‐ups after 6 and 12 months in 10 ED settings in England. From October 2014 to May 2015 we screened 3327 adolescents aged 14 to 18 years, of whom 756 (22.7%) scored at least 3 on the Alcohol Use Disorders Identification Test: consumption (AUDIT‐C) and consented to participate in this trial. Mean age was 16.1 years; 50.2% were female and 84.9% were white. INTERVENTIONS: Interventions were personalized feedback and brief advice (PFBA), personalized feedback plus electronic brief intervention (eBI) and SA. MEASURES: The primary outcome was the weekly alcohol consumed in standard UK units (8 g ethanol) at 12 months post‐randomization, derived from extended AUDIT‐C. Economic outcomes included quality of life and service use, from perspectives of both the National Health Service and personal social services (NHS&PSS) and society. FINDINGS: At 12 months, mean weekly consumption was 2.99 [95% confidence interval (CI) = 2.38–3.70] standard units for the SA group, 3.56 (95% CI = 2.90, 4.32) for PFBA and 3.18 (95% CI = 2.50, 3.97) for eBI, showing no significant differences. The PFBA group consumed mean 0.57 (−0.36, 1.70) units more than SA; and eBIs consumed 0.19 (−0.71, 1.30) more. Bayes factors suggested lack of effectiveness explained non‐significance. From the NHS&PSS perspective, economic analysis showed that PFBA and eBI were not cost‐effective compared with SA: PFBA yielded incremental cost‐effectiveness ratio of £6213 (−£736 843, £812 884), with the intervention having 54% probability of being cost‐effective compared with SA at the £20 000 WTP threshold. CONCLUSIONS: In emergency departments in England, neither personalized feedback and brief advice nor personalized feedback plus electronic brief intervention showed evidence of being effective or cost‐effective when compared with screening alone in reducing alcohol consumption among adolescents. John Wiley and Sons Inc. 2022-04-12 2022-08 /pmc/articles/PMC9540754/ /pubmed/35315170 http://dx.doi.org/10.1111/add.15884 Text en © 2022 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Reports Deluca, Paolo Coulton, Simon Alam, Mohammed Fasihul Boniface, Sadie Donoghue, Kim Gilvarry, Eilish Kaner, Eileen Lynch, Ellen Maconochie, Ian McArdle, Paul McGovern, Ruth Newbury‐Birch, Dorothy Patton, Robert Pellat‐Higgins, Tracy Phillips, Ceri Phillips, Thomas Pockett, Rhys D. Russell, Ian T. Strang, John Drummond, Colin Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
title | Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
title_full | Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
title_fullStr | Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
title_full_unstemmed | Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
title_short | Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
title_sort | effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (sips junior high risk trial) |
topic | Research Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9540754/ https://www.ncbi.nlm.nih.gov/pubmed/35315170 http://dx.doi.org/10.1111/add.15884 |
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