The effectiveness of brief intervention among injured patients with alcohol dependence: Who benefits from brief interventions?

BackgroundResearch investigating the differential effectiveness of Brief Motivational Interventions (BMIs) among alcohol-dependent and non-dependent patients in the medical setting is limited. Clinical guidelines suggest that BMI is most appropriate for patients with less severe alcohol problems. As a result, most studies evaluating the effectiveness of BMI have excluded patients with an indication of alcohol dependence.MethodsA randomized controlled trial of brief intervention in the trauma care setting comparing BMI to treatment as usual plus assessment (TAU+) was conducted. Alcohol dependence status was determined for 1336 patients using DSM-IV diagnostic criteria. The differential effectiveness of BMI among alcohol-dependent and non-dependent patients was determined with regard to volume per week, maximum amount consumed, percent days abstinent, alcohol problems at 6 and 12 months follow-up. In addition, the effect of BMI on dependence status at 6 and 12 months was determined.ResultsThere was a consistent interaction between BMI and alcohol dependence status, which indicated significantly higher reductions in volume per week at 6 and 12 months follow-up (β = −.56, p = .03, β = −.63, p = .02, respectively), maximum amount at 6 months (β = −.31, p = .04), and significant decreases in percent days abstinent at 12 months (β = .11, p = .007) and alcohol problems at 12 months (β = −2.7, p12 = .04) among patients with alcohol dependence receiving BMI. In addition, patients with alcohol dependence at baseline that received BMI were .59 (95% CI = .39–.91) times less likely to meet criteria for alcohol dependence at six months.ConclusionsThese findings suggest that BMI is more beneficial among patients with alcohol dependence who screen positive for an alcohol-related injury.