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Acute alcohol consumption and motivation to reduce drinking among injured patients in a Swedish emergency department.

https://arctichealth.org/en/permalink/ahliterature120290
Source
J Addict Nurs. 2012 Oct;23(3):152-8
Publication Type
Article
Date
Oct-2012
Author
Anna Trinks
Karin Festin
Preben Bendtsen
Cheryl J Cherpitel
Per Nilsen
Author Affiliation
Anna Trinks, MSc, Karin Festin, PhD, Preben Bendtsen, PhD, and Per Nilsen, PhD, Department of Medical and Health Sciences, Linköping, Sweden. Cheryl J. Cherpitel, DrPH, Alcohol Research Group, Berkeley, California.
Source
J Addict Nurs. 2012 Oct;23(3):152-8
Date
Oct-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Binge Drinking - epidemiology - psychology
Emergency Service, Hospital - statistics & numerical data
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Motivation
Prevalence
Risk factors
Sweden - epidemiology
Wounds and Injuries - epidemiology
Young Adult
Abstract
Injuries constitute a major public health problem. Millions of people are injured each year, and acute drinking is a well-known risk factor for injuries. Research suggests that acknowledgment of alcohol as a factor in an injury enhances willingness to change drinking behavior, possibly because the patient becomes aware of the negative consequences of their drinking. This study aims to investigate the prevalence of acute alcohol consumption (drinking before the event) among injury patients and to examine the importance of factors potentially associated with motivation to reduce alcohol consumption among these patients. All patients aged 18-69 years were requested to answer alcohol-related questions on a touchscreen computer. Fifteen percent of injured patients were categorized as acute drinkers, and of these, 64% reported that their injury was connected to alcohol. There were significant differences for all sociodemographic and drinking characteristics between acute drinkers and nonacute drinkers. Acute drinkers were categorized as risky drinkers to a much higher extent than nonacute drinkers. Acute drinkers had a considerably higher average weekly alcohol consumption and engaged far more frequently in heavy episodic drinking than nonacute drinkers. Acute drinkers were motivated to reduce their alcohol intake to a greater extent than nonacute drinkers; 51% were in the action, preparation, and contemplation stages, compared with 19% of the nonacute drinkers. Acute drinkers had considerably more detrimental alcohol consumption than nonacute drinkers, and the acute drinkers were more motivated to reduce their drinking than the nonacute drinkers.
Notes
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PubMed ID
24335731 View in PubMed
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Advice to patients in Swedish primary care regarding alcohol and other lifestyle habits: how patients report the actions of GPs in relation to their own expectations and satisfaction with the consultation.

https://arctichealth.org/en/permalink/ahliterature9145
Source
Eur J Public Health. 2005 Dec;15(6):615-20
Publication Type
Article
Date
Dec-2005
Author
Kjell Johansson
Preben Bendtsen
Ingemar Akerlind
Author Affiliation
Department of Health and Society, Linköping University, Linköping, Sweden. kjejo@ihs.liu.se
Source
Eur J Public Health. 2005 Dec;15(6):615-20
Date
Dec-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alcohol Drinking
Female
Humans
Male
Middle Aged
Patient satisfaction
Physician-Patient Relations
Physicians, Family
Primary Health Care
Questionnaires
Research Support, Non-U.S. Gov't
Risk Reduction Behavior
Sweden
Abstract
BACKGROUND: Lifestyle advice given by general practitioners (GPs) may be a cost-effective means of health promotion; however, it is not fully put into routine practice. The aim of this study was to explore to what extent GPs' patients expect and receive advice concerning alcohol, tobacco, exercise and diet in relation to sociodemographic characteristics, type of visit and patient satisfaction. METHODS: A postal questionnaire was sent to a representative sample (n = 9750) of patients who had consulted GPs in a county in Sweden. The response rate was 69% (n = 6734). RESULTS: Exercise was the most (16%) and alcohol the least (5%) common type of advice. The patients received advice more often than they expected in all areas except alcohol. The patients reported the highest rate of unfulfilled advice expectation and the lowest rate of unexpected advice in the case of alcohol. Male gender, poorer self-rated health and scheduled appointment were independent predictors of all types of advice. Continuity of GP contact was only favourable for exercise and diet advice. The patients who received advice were more satisfied with their visit to the doctor. CONCLUSIONS: A tertiary preventive perspective guides GPs' practice of giving advice. Male patients with advanced illnesses are given priority. Women and patients with long-term risk habits are more neglected. The GPs tend to misjudge the expectations and needs of their patients and are too restrained in their counselling practice. Alcohol is the most disregarded area of advice in proportion to the patients' expectations and needs.
PubMed ID
16093300 View in PubMed
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Alcohol assessment and feedback by email for university students: main findings from a randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature107016
Source
Br J Psychiatry. 2013 Nov;203(5):334-40
Publication Type
Article
Date
Nov-2013
Author
Jim McCambridge
Marcus Bendtsen
Nadine Karlsson
Ian R White
Per Nilsen
Preben Bendtsen
Author Affiliation
Jim McCambridge, PhD, Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, London, UK; Marcus Bendtsen, MSc, Department of Medicine and Health, and Department of Computer and Information Science, Linköping University, Linköping, Sweden; Nadine Karlsson, PhD, Department of Medicine and Health, Linköping University, Linköping, Sweden; Ian R. White, PhD, MRC, Biostatistics Unit, Institute of Public Health, Cambridge, UK; Per Nilsen, PhD, Preben Bendtsen, PhD, Department of Medicine and Health, Linköping University, Linköping, Sweden.
Source
Br J Psychiatry. 2013 Nov;203(5):334-40
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alcohol Drinking - prevention & control - psychology
Binge Drinking - diagnosis - prevention & control - psychology
Electronic Mail
Feedback, Psychological
Female
Humans
Intention to Treat Analysis
Internet
Male
Outcome Assessment (Health Care) - statistics & numerical data
Students - psychology - statistics & numerical data
Sweden
Universities
Young Adult
Abstract
Brief interventions can be efficacious in changing alcohol consumption and increasingly take advantage of the internet to reach high-risk populations such as students.
To evaluate the effectiveness of a brief online intervention, controlling for the possible effects of the research process.
A three-arm parallel groups design was used to explore the magnitude of the feedback and assessment component effects. The three groups were: alcohol assessment and feedback (group 1); alcohol assessment only without feedback (group 2); and no contact, and thus neither assessment nor feedback (group 3). Outcomes were evaluated after 3 months via an invitation to participate in a brief cross-sectional lifestyle survey. The study was undertaken in two universities randomising the email addresses of all 14 910 students (the AMADEUS-1 study, trial registration: ISRCTN28328154).
Overall, 52% (n = 7809) of students completed follow-up, with small differences in attrition between the three groups. For each of the two primary outcomes, there was one statistically significant difference between groups, with group 1 having 3.7% fewer risky drinkers at follow-up than group 3 (P = 0.006) and group 2 scoring 0.16 points lower than group 3 on the three alcohol consumption questions from the Alcohol Use Disorders Identification Test (AUDIT-C) (P = 0.039).
This study provides some evidence of population-level benefit attained through intervening with individual students.
PubMed ID
24072758 View in PubMed
Less detail

Alcohol assessment & feedback by e-mail for university student hazardous and harmful drinkers: study protocol for the AMADEUS-2 randomised controlled trial.

https://arctichealth.org/en/permalink/ahliterature105186
Source
BMC Public Health. 2013;13:949
Publication Type
Article
Date
2013
Author
Jim McCambridge
Marcus Bendtsen
Nadine Karlsson
Ian R White
Preben Bendtsen
Source
BMC Public Health. 2013;13:949
Date
2013
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - prevention & control - psychology
Electronic Mail
Feedback, Psychological
Female
Follow-Up Studies
Humans
Male
Research Design
Risk-Taking
Student Health Services - methods
Students - psychology
Sweden
Therapy, Computer-Assisted
Treatment Outcome
Universities
Abstract
Alcohol is responsible for a large and growing proportion of the global burden of disease, as well as being the cause of social problems. Brief interventions are one component of comprehensive policy measures necessary to reduce these harms. Brief interventions increasingly take advantage of the Internet to reach large numbers of high risk groups such as students. The research literature on the efficacy and effectiveness of online interventions is developing rapidly. Although many studies show benefits in the form of reduced consumption, other intervention studies show no effects, for reasons that are unclear. Sweden became the first country in the world to implement a national system in which all university students are offered a brief online intervention via an e-mail.
This randomized controlled trial (RCT) aims to evaluate the effectiveness of this national system comprising a brief online intervention among university students who are hazardous and harmful drinkers. This study employs a conventional RCT design in which screening to determine eligibility precedes random allocation to immediate or delayed access to online intervention. The online intervention evaluated comprises three main components; assessment, normative feedback and advice on reducing drinking. Screening is confined to a single question in order to minimise assessment reactivity and to prevent contamination. Outcomes will be evaluated after 2 months, with total weekly alcohol consumption being the primary outcome measure. Invitations to participate are provided by e-mail to approximately 55,000 students in 9 Swedish universities.
This RCT evaluates routine service provision in Swedish universities via a delay in offer of intervention to the control group. It evaluates effects in the key population for whom this intervention has been designed. Study findings will inform the further development of the national service provision.
ISRCTN02335307.
Notes
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PubMed ID
24456668 View in PubMed
Less detail

Alcohol email assessment and feedback study dismantling effectiveness for university students (AMADEUS-1): study protocol for a randomized controlled trial.

https://arctichealth.org/en/permalink/ahliterature124868
Source
Trials. 2012;13(1):49
Publication Type
Article
Date
2012
Author
Jim McCambridge
Preben Bendtsen
Marcus Bendtsen
Per Nilsen
Author Affiliation
Faculty of Public Health & Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK. Jim.McCambridge@lshtm.ac.uk
Source
Trials. 2012;13(1):49
Date
2012
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - prevention & control - psychology
Alcoholic Intoxication - prevention & control - psychology
Deception
Electronic Mail
Feedback, Psychological
Humans
Patient Selection
Preventive Health Services
Questionnaires
Research Design
Risk Reduction Behavior
Risk-Taking
Student Health Services
Students - psychology
Sweden
Therapy, Computer-Assisted
Time Factors
Treatment Outcome
Abstract
Alcohol causes huge problems for population health and for society, which require interventions with individuals as well as populations to prevent and reduce harms. Brief interventions can be effective and increasingly take advantage of the internet to reach high-risk groups such as students. The research literature on the effectiveness of online interventions is developing rapidly and is confronted by methodological challenges common to other areas of e-health including attrition and assessment reactivity and in the design of control conditions.
The study aim is to evaluate the effectiveness of a brief online intervention, employing a randomized controlled trial (RCT) design that takes account of baseline assessment reactivity, and other possible effects of the research process. Outcomes will be evaluated after 3 months both among student populations as a whole including for a randomized no contact control group and among those who are risky drinkers randomized to brief assessment and feedback (routine practice) or to brief assessment only. A three-arm parallel groups trial will also allow exploration of the magnitude of the feedback and assessment component effects. The trial will be undertaken simultaneously in 2 universities randomizing approximately 15,300 students who will all be blinded to trial participation. All participants will be offered routine practice intervention at the end of the study.
This trial informs the development of routine service delivery in Swedish universities and more broadly contributes a new approach to the study of the effectiveness of online interventions in student populations, with relevance to behaviors other than alcohol consumption. The use of blinding and deception in this study raise ethical issues that warrant further attention.
ISRCTN28328154.
Notes
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PubMed ID
22540638 View in PubMed
Less detail

Applying the RE-AIM framework to evaluate two implementation strategies used to introduce a tool for lifestyle intervention in Swedish primary health care.

https://arctichealth.org/en/permalink/ahliterature136238
Source
Health Promot Int. 2012 Jun;27(2):167-76
Publication Type
Article
Date
Jun-2012
Author
Siw Carlfjord
Agneta Andersson
Preben Bendtsen
Per Nilsen
Malou Lindberg
Author Affiliation
Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, SE-581 83 Linköping, Sweden. siw.carlfjord@liu.se
Source
Health Promot Int. 2012 Jun;27(2):167-76
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Computers
Female
General Practitioners - psychology
Health Behavior
Health Promotion - methods
Humans
Life Style
Male
Nurses - psychology
Primary Health Care - methods
Sweden
Abstract
The aim of this study was to evaluate two implementation strategies for the introduction of a lifestyle intervention tool in primary health care (PHC), applying the RE-AIM framework to assess outcome. A computer-based tool for lifestyle intervention was introduced in PHC. A theory-based, explicit, implementation strategy was used at three centers, and an implicit strategy with a minimum of implementation efforts at three others. After 9 months a questionnaire was sent to staff members (n= 159) and data from a test database and county council registers were collected. The RE-AIM framework was applied to evaluate outcome in terms of reach, effectiveness, adoption and implementation. The response rate for the questionnaire was 73%. Significant differences in outcome were found between the strategies regarding reach, effectiveness and adoption, in favor of the explicit implementation strategy. Regarding the dimension implementation, no differences were found according to the implementation strategy. A theory-based implementation strategy including a testing period before using a new tool in daily practice seemed to be more successful than a strategy in which the tool was introduced and immediately used for patients.
PubMed ID
21398336 View in PubMed
Less detail

Attitudes and learning through practice are key to delivering brief interventions for heavy drinking in primary health care: Analyses from the ODHIN Five Country Cluster Randomized Factorial Trial.

https://arctichealth.org/en/permalink/ahliterature283531
Source
Int J Environ Res Public Health. 2017 Jan 26;14(2)
Publication Type
Article
Date
Jan-26-2017
Author
Peter Anderson
Eileen Kaner
Myrna Keurhorst
Preben Bendtsen
Ben van Steenkiste
Jillian Reynolds
Lidia Segura
Marcin Wojnar
Karolina Kloda
Kathryn Parkinson
Colin Drummond
Katarzyna Okulicz-Kozaryn
Artur Mierzecki
Miranda Laurant
Dorothy Newbury-Birch
Antoni Gual
Source
Int J Environ Res Public Health. 2017 Jan 26;14(2)
Date
Jan-26-2017
Language
English
Publication Type
Article
Keywords
Adult
Alcohol Drinking - prevention & control
Alcoholic Intoxication - prevention & control
Alcoholism - rehabilitation
Attitude of Health Personnel
England
Female
Health Personnel - education - psychology
Humans
Male
Middle Aged
Netherlands
Outcome Assessment (Health Care)
Poland
Primary Health Care - methods
Referral and Consultation
Spain
Surveys and Questionnaires
Sweden
Abstract
In this paper, we test path models that study the interrelations between primary health care provider attitudes towards working with drinkers, their screening and brief advice activity, and their receipt of training and support and financial reimbursement. Study participants were 756 primary health care providers from 120 primary health care units (PHCUs) in different locations throughout Catalonia, England, The Netherlands, Poland, and Sweden. Our interventions were training and support and financial reimbursement to providers. Our design was a randomized factorial trial with baseline measurement period, 12-week implementation period, and 9-month follow-up measurement period. Our outcome measures were: attitudes of individual providers in working with drinkers as measured by the Short Alcohol and Alcohol Problems Perception Questionnaire; and the proportion of consulting adult patients (age 18+ years) who screened positive and were given advice to reduce their alcohol consumption (intervention activity). We found that more positive attitudes were associated with higher intervention activity, and higher intervention activity was then associated with more positive attitudes. Training and support was associated with both positive changes in attitudes and higher intervention activity. Financial reimbursement was associated with more positive attitudes through its impact on higher intervention activity. We conclude that improving primary health care providers' screening and brief advice activity for heavy drinking requires a combination of training and support and on-the-job experience of actually delivering screening and brief advice activity.
Notes
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PubMed ID
28134783 View in PubMed
Less detail

Attitudes of Swedish general practitioners and nurses to working with lifestyle change, with special reference to alcohol consumption.

https://arctichealth.org/en/permalink/ahliterature9163
Source
Alcohol Alcohol. 2005 Sep-Oct;40(5):388-93
Publication Type
Article
Author
Magnus Geirsson
Preben Bendtsen
Fredrik Spak
Author Affiliation
Ekängsvägen 15, 541 40 Skövde, Sweden. magnus.geirsson@vgregion.se
Source
Alcohol Alcohol. 2005 Sep-Oct;40(5):388-93
Language
English
Publication Type
Article
Keywords
Adult
Alcoholism - prevention & control - psychology - rehabilitation
Attitude of Health Personnel
Education, Medical, Graduate
Female
Health Behavior
Health Knowledge, Attitudes, Practice
Humans
Life Style
Male
Middle Aged
Nurses - psychology
Patient Compliance - psychology
Physicians, Family - psychology
Recurrence - prevention & control
Sweden
Abstract
AIMS: To explore the attitudes of Swedish general practitioners (GPs) and nurses to secondary alcohol prevention (early identification of, and intervention for, alcohol-related problems) and compare it to their attitudes to other important lifestyle behaviours such as smoking, stress, exercise, and overweight. METHODS: An adjusted version of The WHO Collaborative Study Questionnaire for General Practitioners was posted to all GPs and nurses in the County of Skaraborg, Sweden; 68 GPs and 193 nurses responded. RESULTS: The importance of drinking alcohol moderately, counselling skills on reducing alcohol consumption and perceived current effectiveness in helping patients change lifestyle behaviours ranked lower than working with all the other lifestyle behaviours. The nurses rated their potential effectiveness in helping patients change lifestyle higher than that of GPs for all the lifestyle behaviours. Nurses receiving more alcohol-related education had more positive attitudes than nurses with less education. For alcohol, the GPs assessed their role adequacy, role legitimacy and motivation higher than that of the nurses. The main obstacles for the GPs to carry out alcohol intervention were lack of training in counselling for reducing alcohol consumption, time constraints, and the fact that the doctors did not know how to identify problem drinkers who have no obvious symptoms of excess consumption. CONCLUSION: GPs and the nurses estimated their alcohol-related competence as lower than working with many other health-related lifestyles. These results can be explained by lack of practical skills, lack of training in suitable intervention techniques, and unsupportive working environments. All these elements must be considered when planning secondary alcohol prevention programs in primary health care.
PubMed ID
16043435 View in PubMed
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Brief interventions in routine health care: a population-based study of conversations about alcohol in Sweden.

https://arctichealth.org/en/permalink/ahliterature134996
Source
Addiction. 2011 Oct;106(10):1748-56
Publication Type
Article
Date
Oct-2011
Author
Per Nilsen
Jim McCambridge
Nadine Karlsson
Preben Bendtsen
Author Affiliation
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. per.nilsen@liu.se
Source
Addiction. 2011 Oct;106(10):1748-56
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alcohol Drinking - epidemiology - prevention & control - therapy
Alcoholism - epidemiology - prevention & control - therapy
Counseling - methods - statistics & numerical data
Cross-Sectional Studies
Female
Health Knowledge, Attitudes, Practice
Health services
Humans
Logistic Models
Male
Middle Aged
Primary Health Care
Professional-Patient Relations
Questionnaires
Sweden
Time Factors
Young Adult
Abstract
To investigate how brief alcohol interventions are delivered in routine practice in the Swedish health-care system.
A cross-sectional sample of 6000 individuals representative of the adult population aged 18-64 years registered in the Swedish total population register was drawn randomly. Data were collected in 2010 by means of a mail questionnaire. The response rate was 54%.
The questionnaire consisted of 27 questions, of which 15 variables were extracted for use in this study. Whether alcohol had been discussed and the duration, contents, experiences and effects of any conversations about alcohol, as reported by patients themselves, were assessed.
Sixty-six per cent of the respondents had visited health-care services in the past 12 months and 20% of these had had one or more conversations about alcohol during these visits (13% of the population aged 18-64 years). The duration of the conversations was generally brief, with 94% taking less than 5 minutes, and were not experienced as problematic. The duration, contents, experiences and effects of these conversations generally varied between abstainers, moderate, hazardous and excessive drinkers. Twelve per cent of those having a conversation about alcohol reported that it led to reduced alcohol consumption. Reduced alcohol consumption was more likely when conversations lasted for 1-10 minutes rather than less than 1 minute and included advice on how to reduce consumption.
Population survey data in Sweden suggest that when health-care professionals give brief advice to reduce alcohol consumption, greater effects are observed when the advice is longer and includes advice on how to achieve it.
Notes
Comment In: Addiction. 2011 Oct;106(10):1757-921917038
PubMed ID
21518068 View in PubMed
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Can screening and simple written advice reduce excessive alcohol consumption among emergency care patients?

https://arctichealth.org/en/permalink/ahliterature9193
Source
Alcohol Alcohol. 2005 Sep-Oct;40(5):401-8
Publication Type
Article
Author
Cecilia Nordqvist
Elisabeth Wilhelm
Kent Lindqvist
Preben Bendtsen
Author Affiliation
Department of Health and Society, Division of Social Medicine and Public Health Science, Linköping University, S-581 83 Linköping Sweden. cecno@ihs.liu.se
Source
Alcohol Alcohol. 2005 Sep-Oct;40(5):401-8
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Alcohol Drinking - adverse effects
Alcoholic Intoxication - diagnosis - prevention & control - psychology
Alcoholism - diagnosis - prevention & control - psychology
Emergency Service, Hospital
Female
Follow-Up Studies
Health education
Health Knowledge, Attitudes, Practice
Humans
Male
Mass Screening
Middle Aged
Pamphlets
Questionnaires
Research Support, Non-U.S. Gov't
Sweden
Wounds and Injuries - prevention & control - psychology
Abstract
AIMS: Emergency care patients have an overrepresentation of risky drinkers. Despite the evidence on the effectiveness of a short feedback on screening or self-help material, most studies performed so far have required considerable time from staff and thus been difficult to implement in the real world. The present study evaluates the effect of the screening and whether simple written advice has any additional effect on risky drinking. METHODS: An alcohol screening routine was implemented among injury patients in a Swedish emergency care department. Over 12 months, two cohorts were invited to answer an alcohol screening questionnaire in the waiting room. In the first 6 months, 771 patients were screened without any written advice (cohort A) and in the following 6 months, 563 were screened and in addition received simple written advice about sensible drinking (cohort B). None of the patients received one-to-one feedback. Six months after the screening, a follow-up interview by telephone explored the changes in drinking. RESULTS: In cohort A 182 (24%) of the patients were defined as risky drinkers and in cohort B 125 (22%). Reached at follow-up after 6 months were 81 (44%) risky and 278 (47%) non-risky drinkers in cohort A, and 40 (32%) risky and 220 (50%) non-risky drinkers in cohort B. The number of patients with heavy episodic drinking decreased significantly in cohort A from 76 (94% of the risky drinkers) to 49 (59%). In cohort B a similar change was seen from 37 (92%) to 27 (68%). Only in cohort B, was a significant increase in readiness to change drinking habits seen [from 3 (8%) to 9 (23%)]. The reduction in heavy episodic drinking was comparable with previous reports from more extensive interventions. However, at the time of follow-up, drinking among non-risky drinkers at baseline had increased. When considering the greater numbers of non-risky drinkers, the total consumption in the study group increased during the study period. CONCLUSIONS: Owing to the reported difficulties of integrating more time-consuming alcohol interventions in emergency departments, it is suggested that at least screening for drinking should be implemented as routine in emergency departments. More research is needed in order to establish the optimal balance between effective alcohol intervention, and acceptable time and effort requirement from staff.
Notes
Erratum In: Alcohol Alcohol. 2006 Jan-Feb;41(1):118
PubMed ID
15955776 View in PubMed
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