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Brief interventions to prevent excessive alcohol use in adolescents at low-risk presenting to Emergency Departments: Three-arm, randomised trial of effectiveness and cost-effectiveness.

  • Deluca, Paolo1
  • Coulton, Simon2
  • Alam, Mohammed Fasihul3
  • Boniface, Sadie4
  • Cohen, David5
  • Donoghue, Kim4
  • Gilvarry, Eilish6
  • Kaner, Eileen7
  • Maconochie, Ian8
  • McArdle, Paul6
  • McGovern, Ruth7
  • Newbury-Birch, Dorothy9
  • Patton, Robert10
  • Pellatt-Higgins, Tracy2
  • Phillips, Ceri11
  • Phillips, Thomas12
  • Pockett, Rhys D11
  • Russell, Ian13
  • Strang, John4
  • Drummond, Colin4
  • 1 Institute of Psychiatry, Psychology & Neuroscience, King's College London, London UK. Electronic address: [email protected]
  • 2 Centre for Health Services Studies, University of Kent, Canterbury, UK.
  • 3 College of Health Sciences, QU Health, Qatar University, Doha, Qatar. , (Qatar)
  • 4 Institute of Psychiatry, Psychology & Neuroscience, King's College London, London UK.
  • 5 Health Economics and Policy Research Unit, University of South Wales, Pontypridd, UK.
  • 6 Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK.
  • 7 Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.
  • 8 Paediatric Emergency Medicine, Imperial College, London, UK.
  • 9 School of Social Sciences, Humanities and Law, Teesside University, Middlesbrough, UK.
  • 10 School of Psychology, University of Surrey, Guildford, UK.
  • 11 Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, Wales, UK.
  • 12 Institute of Psychiatry, Psychology & Neuroscience, King's College London, London UK; Institute for Clinical and Applied Health Research, University of Hull, Hull, UK.
  • 13 Medical School, Swansea University, Swansea, Wales, UK.
Published Article
The International journal on drug policy
Publication Date
Jul 01, 2021
DOI: 10.1016/j.drugpo.2021.103113
PMID: 33487528


Alcohol consumption and related harm increase rapidly from the age of 12 years. We evaluated whether alcohol screening and brief intervention is effective and cost-effective in delaying hazardous or harmful drinking amongst low-risk or abstaining adolescents attending Emergency Departments (EDs). This ten-centre, three-arm, parallel-group, single-blind, pragmatic, individually randomised trial screened ED attenders aged between 14 and 17 years for alcohol consumption. We sampled at random one third of those scoring at most 2 on AUDIT-C who had access to the internet and, if aged under 16, were Gillick competent or had informed consent from parent or guardian. We randomised them between: screening only (control intervention); one session of face-to-face Personalised Feedback and Brief Advice (PFBA); and PFBA plus an electronic brief intervention (eBI) on smartphone or web. We conducted follow-up after six and 12 months. The principal outcomes were alcohol consumed over the 3 months before 12-month follow up, measured by AUDIT-C; and quality-adjusted life-years. Between October 2014 and May 2015, we approached 5,016 eligible patients of whom 3,326 consented to be screened and participate in the trial; 2,571 of these were low-risk drinkers or abstainers, consuming an average 0.14 units per week. We randomised: 304 to screening only; 285 to PFBA; and 294 to PFBA and eBI. We found no significant difference between groups, notably in weekly alcohol consumption: those receiving screening only drank 0.10 units (95% confidence interval 0.05 to 0.18); PFBA 0.12 (0.06 to 0.21); PFBA and eBI 0.10 (0.05 to 0.19). While drinking levels remained low in this population, this trial found no evidence that PFBA with or without eBI was more effective than screening alone in reducing or delaying alcohol consumption. Copyright © 2021. Published by Elsevier B.V.

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