Investigating the effect of Alcohol Brief Interventions within Accident & Emergency departments using data informatics methodology

Abstract

Background: Alcohol Brief Interventions (ABI) have been implemented throughout Scotland since 2008 aiming to reduce hazardous drinking through a Scottish government funded initiative delivered in a range of setting including Accident and Emergency (A&E) departments. Purpose: To study the extent to Alcohol Brief Interventions (ABI) is associated with later health service use. Method: An opportunistic informatics approach was applied. A unique patient identifier was used to link patient data with core datasets spanning two years previous and two years post ABI. Variables included inpatient attendance, outpatient attendance, psychiatric admissions, A&E attendance and prescribing. Patients (N = 1704) who presented at A&E departments reported an average alcohol consumption of more than 8 units daily received the ABI. Fast Alcohol Screening Test (FAST) was used to assess patients for hazardous alcohol consumption. Multilevel linear modelling was employed to predict post-intervention utilisation using pre-ABI variables and controlling for person characteristics and venue. Results: Significant decrease in A&E usage was found at one and two years following the ABI intervention. Previous health service use was predictive of later service use. A single question (Item 4) on the FAST was predictive of A&E attendance at one and two years. Conclusions: This investigation and methodology used provides support for the delivery of the ABI. However it cannot be ascertained as to whether this is due to the ABI, or simply as a result of making contact with a specialist in the addiction field.