Screening, brief intervention and referral to treatment (SBIRT) in a Polish emergency room

A randomized trial of screening, brief intervention and referral to treatment (SBIRT) was undertaken in an emergency room (ER) in Sosnowiec, Poland, and is the first outside of the U.S. to test protocols of the NIAAA-funded U.S. 14-site SBIRT study. Eligibility criteria were18 or older, a positive RAPS4 (as an indicator of alcohol dependence), or 11 + Polish drinks (PD) for males/ 6 + for females per week during the last year, or 4+ PD for males/3+ for females on an occasion in the last 30 days (following NIAAA guidelines for harmful drinking; a Polish drink contains 20 ml of ethanol). Patients were screened over a 23-week period (2007), 4:00 pm to midnight, seven days a week. 23% screened positive (445) and were randomized: screened only (n=149), screened and assessed (n=151), screened, assessed and intervention (n=145). 15% were female. ER nurses were trained to provide the intervention. No difference was found on baseline screening variables across groups. A follow-up rate of 85% was achieved at three months, at which time all three groups showed a decline in the RAPS4 score, mean number of drinking days, mean number of drinks per day, and number of 4+/3+ days in the last 30 days, but the intervention group showed a larger change than the other two groups. Findings suggest that the U.S.-based SBIRT protocols can be successfully transported to another culture, and that nurses can be successfully trained to integrate brief intervention for problem drinking along with other duties in the ER setting.