Dataset Information

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients.

ABSTRACT:

Objective

Estimate the effectiveness of brief interventions in reducing trauma recidivism in hospitalized trauma patients who screened positive for alcohol and/or illicit drug use.

Methods

Dynamic cohort study based on registry data from 1818 patients included in a screening and brief intervention program for alcohol and illicit drug use for hospitalized trauma patients. Three subcohorts emerged from the data analysis: patients who screened negative, those who screened positive and were offered brief intervention, and those who screened positive and were not offered brief intervention. Follow-up lasted from 10 to 52 months. Trauma-free survival, adjusted hazard rate ratios (aHRR) and adjusted incidence rate ratios (aIRR) were calculated, and complier average causal effect (CACE) analysis was used.

Results

We found a higher cumulative risk of trauma recidivism in the subcohort who screened positive. In this subcohort, an aHRR of 0.63 (95% CI: 0.41-0.95) was obtained for the group offered brief intervention compared to the group not offered intervention. CACE analysis yielded an estimated 52% reduction in trauma recidivism associated with the brief intervention.

Conclusion

The brief intervention offered during hospitalization in trauma patients positive for alcohol and/or illicit drug use can halve the incidence of trauma recidivism.

SUBMITTER: Cordovilla-Guardia S

PROVIDER: S-EPMC5559089 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients.

Cordovilla-Guardia Sergio S Fernández-Mondéjar Enrique E Vilar-López Raquel R Navas Juan F JF Portillo-Santamaría Mónica M Rico-Martín Sergio S Lardelli-Claret Pablo P

PloS one 20170816 8

<h4>Objective</h4>Estimate the effectiveness of brief interventions in reducing trauma recidivism in hospitalized trauma patients who screened positive for alcohol and/or illicit drug use.<h4>Methods</h4>Dynamic cohort study based on registry data from 1818 patients included in a screening and brief intervention program for alcohol and illicit drug use for hospitalized trauma patients. Three subcohorts emerged from the data analysis: patients who screened negative, those who screened positive an ...[more]

PMID: 28813444

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Project description:Background/Objectives: Substance use during pregnancy is associated with adverse outcomes for both mother and child. This study aimed to determine the prevalence and determinants of alcohol, tobacco and illicit drug use before and during pregnancy in Belgium. Methods: An observational study was conducted using data from the longitudinal BELpREG registry. The study included women aged 18 years or older who completed at least one questionnaire on substance use during pregnancy between 2022 and 2024. Data were analyzed using descriptive statistics and logistic regressions. Results: In total, 1441 women were included. Preconception prevalences of alcohol, tobacco and illicit drug use were 82.2%, 10.0% and 4.2%. These self-reported prevalences dropped in the first trimester to 12.9%, 4.1% and 0.6%, respectively. Considering the rates of substance use in pregnancy but before pregnancy awareness, the overall prevalence of alcohol, tobacco and illicit drug use in the first trimester was 41.0%, 6.6% and 1.2%, respectively. Women with a higher education (aOR (adjusted odds ratio), 2.12; 95% CI (confidence interval): 1.14-3.96), unplanned pregnancies (aOR, 2.88; 95% CI: 1.77-4.67), spontaneous pregnancies (aOR, 2.94; 95% CI: 1.51-5.75), cohabitants drinking alcohol daily (aOR, 2.01; 95% CI: 1.09-3.70), and those using tobacco in the first trimester (aOR, 5.37; 95% CI: 2.70-10.66) were more likely to report alcohol use. In addition, women with a lower education (aOR, 7.67; 95% CI: 3.76-15.67), unplanned pregnancies (aOR, 3.31; 95% CI: 1.53-7.15), cohabitants using tobacco (aOR, 9.11; 95% CI: 4.48-18.52), and those who used alcohol (aOR, 6.67; 95% CI: 3.07-14.64) or illicit drugs (aOR, 39.03; 95% CI: 3.72-409.83) in the first trimester were more likely to report tobacco use. Conclusions: Despite a significant reduction in substance use in pregnancy compared to before pregnancy, a relevant portion of women continue to use substances, particularly in the early stages before pregnancy awareness. Targeted public health interventions and (more) awareness among caregivers are needed to further promote substance use cessation before conception.

Project description:Most previous brief intervention (BI) studies have focused on alcohol or drug use, instead of both substances. Our primary aim was to determine if an alcohol- and drug-use BI reduced alcohol use and increased alcohol treatment services utilization among adult emergency department (ED) patients who drink alcohol and require an intervention for their drug use. Our secondary aims were to assess when the greatest relative reductions in alcohol use occurred, and which patients (stratified by need for an alcohol use intervention) reduced their alcohol use the most. In this secondary analysis, we studied a sub-sample of participants from the Brief Intervention for Drug Misuse in the Emergency Department (BIDMED) randomized, controlled trial of a BI vs. no BI, whose responses to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) indicated a need for a BI for any drug use, and who also reported alcohol use. Participants were stratified by their ASSIST alcohol subscore: 1) no BI needed, 2) a BI needed, or 3) an intensive intervention needed for alcohol use. Alcohol use and alcohol treatment services utilization were measured every 3 months for 12 months post-enrollment. Of these 833 participants, median age was 29 years-old, 46% were female; 55% were white/non-Hispanic, 27% black/non-Hispanic, and 15% Hispanic. Although any alcohol use, alcohol use frequency, days of alcohol use, typical drinks consumed/day, and most drinks consumed/day decreased in both the BI and no BI arms, there were no differences between study arms. Few patients sought alcohol use treatment services in follow-up, and utilization also did not differ by study arm. Compared to baseline, alcohol use reduced the most during the first 3 months after enrollment, yet reduced little afterward. Participants whose ASSIST alcohol subscores indicated a need for an intensive intervention generally had the greatest relative decreases in alcohol use. These results indicate that the BI was not efficacious in reducing alcohol use among alcohol- and drug-using adult ED patients than the self-assessments alone, but suggest that self-assessments with or without a BI may confer reductions in alcohol use.

Dataset Information

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients.

Objective

Methods

Results

Conclusion

Publications

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients.

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