OBJECTIVES We evaluated the relative effectiveness of 2 interventions for patients with alcohol problems.
STUDY DESIGN A nonrandomized intervention study was used to compare usual care (control) with a 5- to 15-minute physician-delivered message (brief intervention) and with the physician message plus a 30- to 60-minute visit by a recovering alcoholic (peer intervention).
Telephone follow-up was obtained up to 12 months after hospital discharge that focused on patient behaviors during the first 6 months following discharge.
POPULATION We included 314 patients with alcohol-related injuries admitted to an urban teaching hospital.
OUTCOMES MEASURED We measured complete abstinence from alcohol during the entire 6 months following hospital discharge, abstinence from alcohol during the sixth month following hospital discharge, and initiation of alcohol treatment or self-help within 6 months of hospital discharge.
RESULTS Valid responses were obtained from 140 patients (45%).
- Observed success rates were: 34%, 44%, and 59% (P=.012) for abstinence from alcohol since discharge in the usual care group, the brief intervention group, and the peer intervention group,respectively;
- 36%, 51%, and 64% (P=.006) for abstinence at the sixth month following hospital discharge;
- and 9%, 15%, and 49% (P<.001) for initiation of treatment/self-help.
During the telephone follow-up interview, several patients in the peer intervention group expressed gratitude for the help they received with their drinking problems while in the hospital.
A few patients went from being unemployed and home-less to having full-time employment and a permanent residence.
They believed the Alcoholics Anonymous peer intervention to be the factor that most motivated them to seek help for their alcohol use disorder. One of these individuals now serves as a volunteer, visiting hospitalized patients with drinking problems.
CONCLUSIONS Among trauma victims with injuries severe enough to require hospital admission, brief advice from a physician followed by a visit with a recovering alcoholic appears to be an effective intervention for problem drinking.
Physicians can request that members of Alcoholics Anonymous (AA) visit their hospitalized patients who have alcohol use disorders.
Interventions by recovering alcoholics are part of their twelfth-step work (an essential part of the AA program) and are simple, practical, involve no costs, and pose little patient risk. They can be arranged from the patient’s bedside telephone. Some patients may show a beneficial response to these peer visits. See BriefTSF training.
Blondell, Richard D., Looney, Stephen W. Northington, Alan P.; Lasch, Mary Ellen Rhodes, Sandra B. McDaniels, Regina L. The Journal of Family Practice, Volume 50(5), May 2001, p 447, Can Recovering Alcoholics Help Hospitalized Patients with Alcohol Problems?
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