Deluca, Paolo;
Coulton, Simon;
Alam, Mohammed Fasihul;
Boniface, Sadie;
Donoghue, Kim;
Gilvarry, Eilish;
Kaner, Eileen;
... Drummond, Colin; + view all
(2022)
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).
Addiction
, 117
(8)
pp. 2200-2214.
10.1111/add.15884.
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Abstract
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: Multi-centre, three-group, single-blind, individually randomised trial with follow-ups after 6 and 12 months. SETTINGS: Ten ED in England. PARTICIPANTS: From October 2014 to May 2015, we screened 3,327 adolescents, aged 14 to 18, 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 females and 84.9% were white. INTERVENTIONS: Interventions were personalised feedback and brief advice (PFBA), personalised feedback plus electronic brief intervention (eBI) and SA. MEASURES: The primary outcome was the weekly alcohol consumed in standard UK units (8 grams of ethanol) at 12 months post-randomisation, derived from extended AUDIT-C. Economic outcomes included quality of life and service use, from perspectives of both the National Health Service & personal social services (NHS&PSS) and society FINDINGS: At 12 months, mean weekly consumption was 2.99 (95% confidence interval [C.I.] from 2.38 to 3.70) standard units for SA group, 3.56 (2.90, 4.32) for PFBA, and 3.18 (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 PFBA and eBI were not cost-effective compared with SA: PFBA yielded incremental cost-effectiveness ratio of £6,213 (-£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 personalised feedback and brief advice nor personalised feedback plus electronic brief intervention showed evidence of being effective or cost-effective when compared with screening alone in reducing alcohol consumption among adolescents.
| Type: | Article |
|---|---|
| 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) |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/add.15884 |
| Publisher version: | https://doi.org/10.1111/add.15884 |
| Language: | English |
| Additional information: | © 2022 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Adolescent, Alcohol, Alcohol screening, Brief intervention, Cost-effectiveness, Effectiveness, Electronic brief intervention, Emergency Department, High risk, Pragmatic randomised trial |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10146116 |
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