Readiness to Change and Reasons for Intended Reduction of Alcohol Consumption in Emergency Department versus Trauma Population

Introduction: The primary objective was to identify the most common reasons for intending to cut back on alcohol use, in emergency department (ED) and trauma patient populations. The secondary objective was to determine the association between reason to cut back on alcohol and education level.Methods: We conducted the study at a level one trauma center in California between 2008 and 2012. This was a retrospective analysis of data collected from computerized alcohol screening and intervention (CASI). We excluded patients who drank too little, and those whose scores were consistent with dependency (Alcohol Use Disorders Identification Test [AUDIT]>19). The CASI database includes the patient’s age, gender, language, education level, an AUDIT score (1-40 scale), a readiness to change score (1-10), and the option to choose any of 10 “reasons to cut back” on their alcohol consumption.Results: From 10,537 patients, 1,202 met criteria for the study (848 ED, 354 trauma). Overall, the most common reasons cited for cutting back on alcohol were “To avoid health problems” (68.5%), “To avoid getting a DUI” (43.6%), “It could save me money” (42.0%), and “To avoid situations where I could get hurt” (41.0%). Trauma patients cited the following reasons significantly more than ED patients: “To avoid situations where I could get hurt” (46.3% versus 38.8%, respectively), “So I can be in control of my behavior” (40.7% versus 32.2%), and “My partner or spouse wants me to stop” (20.1% versus 15.0%). Additionally, those patients who cited “To avoid health problems” reported 1.2 points higher than average (p<0.001) on the 10-point readiness to change scale. Those who have completed some college or an associate degree cited “To avoid health problems” less often than high school graduates (odds ratio [OR] 0.45), while they cited “To avoid situations where I could get hurt” (OR 2.5) and “To avoid being in a car crash caused by alcohol use” (OR 3.8) more often than high school graduates.Conclusion: Health, injury, finances, and legal issues remain top concerns for patients, while trauma patients specifically had proportionately more concerns with situations where they could get hurt. [West J Emerg Med. 2014;15(3):337–344.

Readiness to Change and Reasons for Intended Reduction of Alcohol Consumption in Emergency Department versus Trauma Population

Introduction: The primary objective was to identify the most common reasons for intending to cut back on alcohol use, in emergency department (ED) and trauma patient populations. The secondary objective was to determine the association between reason to cut back on alcohol and education level.Methods: We conducted the study at a level one trauma center in California between 2008 and 2012. This was a retrospective analysis of data collected from computerized alcohol screening and intervention (CASI). We excluded patients who drank too little, and those whose scores were consistent with dependency (Alcohol Use Disorders Identification Test [AUDIT]>19). The CASI database includes the patient’s age, gender, language, education level, an AUDIT score (1-40 scale), a readiness to change score (1-10), and the option to choose any of 10 “reasons to cut back” on their alcohol consumption.Results: From 10,537 patients, 1,202 met criteria for the study (848 ED, 354 trauma). Overall, the most common reasons cited for cutting back on alcohol were “To avoid health problems” (68.5%), “To avoid getting a DUI” (43.6%), “It could save me money” (42.0%), and “To avoid situations where I could get hurt” (41.0%). Trauma patients cited the following reasons significantly more than ED patients: “To avoid situations where I could get hurt” (46.3% versus 38.8%, respectively), “So I can be in control of my behavior” (40.7% versus 32.2%), and “My partner or spouse wants me to stop” (20.1% versus 15.0%). Additionally, those patients who cited “To avoid health problems” reported 1.2 points higher than average (p<0.001) on the 10-point readiness to change scale. Those who have completed some college or an associate degree cited “To avoid health problems” less often than high school graduates (odds ratio [OR] 0.45), while they cited “To avoid situations where I could get hurt” (OR 2.5) and “To avoid being in a car crash caused by alcohol use” (OR 3.8) more often than high school graduates.Conclusion: Health, injury, finances, and legal issues remain top concerns for patients, while trauma patients specifically had proportionately more concerns with situations where they could get hurt. [West J Emerg Med. 2014;15(3):337–344.

Readiness to Change and Reasons for Intended Reduction of Alcohol Consumption in Emergency Department versus Trauma Population

Introduction: The primary objective was to identify the most common reasons for intending to cut back on alcohol use, in emergency department (ED) and trauma patient populations. The secondary objective was to determine the association between reason to cut back on alcohol and education level. Methods: We conducted the study at a level one trauma center in California between 2008 and 2012. This was a retrospective analysis of data collected from computerized alcohol screening and intervention (CASI). We excluded patients who drank too little, and those whose scores were consistent with dependency (Alcohol Use Disorders Identification Test [AUDIT]>19). The CASI database includes the patient’s age, gender, language, education level, an AUDIT score (1-40 scale), a readiness to change score (1-10), and the option to choose any of 10 “reasons to cut back” on their alcohol consumption. Results: From 10,537 patients, 1,202 met criteria for the study (848 ED, 354 trauma). Overall, the most common reasons cited for cutting back on alcohol were “To avoid health problems” (68.5%), “To avoid getting a DUI” (43.6%), “It could save me money” (42.0%), and “To avoid situations where I could get hurt” (41.0%). Trauma patients cited the following reasons significantly more than ED patients: “To avoid situations where I could get hurt” (46.3% versus 38.8%, respectively), “So I can be in control of my behavior” (40.7% versus 32.2%), and “My partner or spouse wants me to stop” (20.1% versus 15.0%). Additionally, those patients who cited “To avoid health problems” reported 1.2 points higher than average (p<0.001) on the 10-point readiness to change scale. Those who have completed some college or an associate degree cited “To avoid health problems” less often than high school graduates (odds ratio [OR] 0.45), while they cited “To avoid situations where I could get hurt” (OR 2.5) and “To avoid being in a car crash caused by alcohol use” (OR 3.8) more often than high school graduates. Conclusion: Health, injury, finances, and legal issues remain top concerns for patients, while trauma patients specifically had proportionately more concerns with situations where they could get hurt

Assessment of Alcohol Use Patterns Among Spanish-Speaking Patients

ObjectiveTo assess drinking patterns of Spanish-speaking patients using a bilingual Computerized Alcohol Screening and brief Intervention (CASI) tablet computer equipped with the Alcohol Use Disorders Identification Test (AUDIT).MethodsThis retrospective study was conducted in a tertiary university hospital emergency department (ED) between 2006 and 2010. Data from 1,816 Spanish-speaking ED patients was analyzed using descriptive statistics, the chi-square test for independence, and the Kruskal-Wallis rank sum test for comparisons using quantitative variables.ResultsOverall, 15% of Spanish-speaking patients were at-risk drinkers, and 5% had an AUDIT score consistent with alcohol dependency (≥20). A higher percentage of Spanish-speaking males than females were at-risk drinkers or likely dependent. Spanish speaking males exhibited higher frequency of drinking days per week and higher number of drinks per day compared to females. Among older patients, non-drinking behavior increased and at-risk drinkers decreased. The majority of males and females were ready to change their behavior after the CASI intervention; 61% and 69% respectively scored 8-10.ConclusionsThis study indicated that CASI was an effective tool for detecting at-risk and likely dependent drinking behavior in Spanish-speaking ED patients. The majority of patients were ready to change their drinking behavior. More alcohol screening and brief intervention tools should be tested and become readily accessible for Spanish-speaking patients

Increased Detection of Alcohol Consumption and At-risk Drinking with Computerized Alcohol Screening

BackgroundThe impact of alcohol use has been widely studied and is considered a public health issue. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends Screening and Brief Intervention and Referral Treatment (SBIRT) but the actual practice in the Emergency Department (ED) is constrained due to limited provider time and financial resources.ObjectivesTo assess the effectiveness of alcohol screening using Computerized Alcohol Screening and brief Intervention (CASI) compared to alcohol screening by triage nurse during Medical Screening Examination (MSE) in the ED.MethodsRetrospective review of CASI/MSE database from January 2008 through December 2009, collected in the tertiary, level I Trauma ED was performed. Inclusion criteria included age ≥18, and completion of both the MSE and CASI. We analyzed the database by comparing age, gender, primary language (English, Spanish), and Alcohol Use Disorders Identification Test (AUDIT) scores using McNemar’s analysis.ResultsData was available for 5,835 patients. CASI showed a significant increase in detection of at-risk drinking over MSE across all ages, gender, and primary language (p&lt;.05). MSE found 2.5% at-risk drinkers while CASI found 11.5% at risk drinkers (Odds ratio 8.88, 95%CI 6.89–11.61). Similar results were found in 18 to 20 year-old patients. MSE identified 1.7% at-risk drinkers and CASI reported 15.94%. (Odds ratio 19.33, 95% CI 6.29–96.74)ConclusionCASI increased detection of at-risk alcohol drinkers compared with MSE across all ages, gender, and primary language. CASI is a promising innovative method for alcohol screening in the ED for the adult population including under-aged drinkers

Assessment of Alcohol Use Patterns Among Spanish-Speaking Patients

ObjectiveTo assess drinking patterns of Spanish-speaking patients using a bilingual Computerized Alcohol Screening and brief Intervention (CASI) tablet computer equipped with the Alcohol Use Disorders Identification Test (AUDIT).MethodsThis retrospective study was conducted in a tertiary university hospital emergency department (ED) between 2006 and 2010. Data from 1,816 Spanish-speaking ED patients was analyzed using descriptive statistics, the chi-square test for independence, and the Kruskal-Wallis rank sum test for comparisons using quantitative variables.ResultsOverall, 15% of Spanish-speaking patients were at-risk drinkers, and 5% had an AUDIT score consistent with alcohol dependency (≥20). A higher percentage of Spanish-speaking males than females were at-risk drinkers or likely dependent. Spanish speaking males exhibited higher frequency of drinking days per week and higher number of drinks per day compared to females. Among older patients, non-drinking behavior increased and at-risk drinkers decreased. The majority of males and females were ready to change their behavior after the CASI intervention; 61% and 69% respectively scored 8-10.ConclusionsThis study indicated that CASI was an effective tool for detecting at-risk and likely dependent drinking behavior in Spanish-speaking ED patients. The majority of patients were ready to change their drinking behavior. More alcohol screening and brief intervention tools should be tested and become readily accessible for Spanish-speaking patients

Increased Detection of Alcohol Consumption and At-risk Drinking with Computerized Alcohol Screening

BackgroundThe impact of alcohol use has been widely studied and is considered a public health issue. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends Screening and Brief Intervention and Referral Treatment (SBIRT) but the actual practice in the Emergency Department (ED) is constrained due to limited provider time and financial resources.ObjectivesTo assess the effectiveness of alcohol screening using Computerized Alcohol Screening and brief Intervention (CASI) compared to alcohol screening by triage nurse during Medical Screening Examination (MSE) in the ED.MethodsRetrospective review of CASI/MSE database from January 2008 through December 2009, collected in the tertiary, level I Trauma ED was performed. Inclusion criteria included age ≥18, and completion of both the MSE and CASI. We analyzed the database by comparing age, gender, primary language (English, Spanish), and Alcohol Use Disorders Identification Test (AUDIT) scores using McNemar’s analysis.ResultsData was available for 5,835 patients. CASI showed a significant increase in detection of at-risk drinking over MSE across all ages, gender, and primary language (p&lt;.05). MSE found 2.5% at-risk drinkers while CASI found 11.5% at risk drinkers (Odds ratio 8.88, 95%CI 6.89–11.61). Similar results were found in 18 to 20 year-old patients. MSE identified 1.7% at-risk drinkers and CASI reported 15.94%. (Odds ratio 19.33, 95% CI 6.29–96.74)ConclusionCASI increased detection of at-risk alcohol drinkers compared with MSE across all ages, gender, and primary language. CASI is a promising innovative method for alcohol screening in the ED for the adult population including under-aged drinkers

Assessment of readiness to change and relationship to AUDIT score in a trauma population utilizing computerized alcohol screening and brief intervention

PurposeTrauma patient readiness to change score and its relationship to the Alcohol Use Disorder Identification Test (AUDIT) score were assessed in addition to the feasibility of Computerized Alcohol Screening and Brief Intervention (CASI).MethodsA bilingual computerized tablet for trauma patients was utilized and the data was analyzed using Stata.ResultsTwenty-five percent of 1,145 trauma patients drank more than recommended and 4% were dependent. As many Spanish-speaking as English-speaking males did not drink, but a higher percentage of Spanish-speaking males drank more than recommended and were dependent. Half of patients who drank more than recommended rated themselves eight or higher on a 10-point readiness-to-change scale. CASI also provided personalized feedback. A high percentage of trauma patients (92%) found CASI easy and a comfort in use (87%).ConclusionBilingual computerized technology for trauma patients is feasible, acceptable, and an innovative approach to alcohol screening, brief intervention and referral to treatment in a tertiary care university

Assessment of readiness to change and relationship to AUDIT score in a trauma population utilizing computerized alcohol screening and brief intervention

PurposeTrauma patient readiness to change score and its relationship to the Alcohol Use Disorder Identification Test (AUDIT) score were assessed in addition to the feasibility of Computerized Alcohol Screening and Brief Intervention (CASI).MethodsA bilingual computerized tablet for trauma patients was utilized and the data was analyzed using Stata.ResultsTwenty-five percent of 1,145 trauma patients drank more than recommended and 4% were dependent. As many Spanish-speaking as English-speaking males did not drink, but a higher percentage of Spanish-speaking males drank more than recommended and were dependent. Half of patients who drank more than recommended rated themselves eight or higher on a 10-point readiness-to-change scale. CASI also provided personalized feedback. A high percentage of trauma patients (92%) found CASI easy and a comfort in use (87%).ConclusionBilingual computerized technology for trauma patients is feasible, acceptable, and an innovative approach to alcohol screening, brief intervention and referral to treatment in a tertiary care university

Assessment of Alcohol Use Patterns Among Spanish-Speaking Patients

OBJECTIVE: To assess drinking patterns of Spanish-speaking patients using a bilingual Computerized Alcohol Screening and brief Intervention (CASI) tablet computer equipped with the Alcohol Use Disorders Identification Test (AUDIT). METHODS: This retrospective study was conducted in a tertiary university hospital emergency department (ED) between 2006 and 2010. Data from 1,816 Spanish-speaking ED patients was analyzed using descriptive statistics, the chi-square test for independence, and the Kruskal-Wallis rank sum test for comparisons using quantitative variables. RESULTS: Overall, 15% of Spanish-speaking patients were at-risk drinkers, and 5% had an AUDIT score consistent with alcohol dependency (≥20). A higher percentage of Spanish-speaking males than females were at-risk drinkers or likely dependent. Spanish speaking males exhibited higher frequency of drinking days per week and higher number of drinks per day compared to females. Among older patients, non-drinking behavior increased and at-risk drinkers decreased. The majority of males and females were ready to change their behavior after the CASI intervention; 61% and 69% respectively scored 8-10. CONCLUSIONS: This study indicated that CASI was an effective tool for detecting at-risk and likely dependent drinking behavior in Spanish-speaking ED patients. The majority of patients were ready to change their drinking behavior. More alcohol screening and brief intervention tools should be tested and become readily accessible for Spanish-speaking patients