Screening, brief intervention and referral to treatment (SBIRT): 12-month outcomes of a randomized controlled clinical trial in a Polish emergency department

A randomized controlled trial of screening, brief intervention and referral to treatment (SBIRT) among at-risk and dependent drinkers was conducted in an emergency department (ED) among 446 patients 18 and older in Sosnowiec, Poland. Patients were randomized to one of three conditions: screened-only (n=147), assessed (n=152), and intervention (n=147). Patients in the assessed and intervention conditions were blindly reassessed via a telephone interview at 3 months, and all three groups assessed at 12 months (screened only = 92, assessed = 99, intervention = 87). At 12 months all three groups showed a significant reduction in at-risk drinking and number of drinks per drinking day. Significant declines were also observed for the RAPS4, number of drinking days per week and maximum number of drinks on an occasion for the intervention condition, and in negative consequences for both assessment and intervention conditions. No significant differences were found across groups for any of the outcomes at 12 months. While the intervention condition appeared to continue to improve in drinking outcomes between 3-month and 12-month follow-up, improvements found in the assessment condition at 3-months deteriorated by 12-month follow-up, and approached baseline values for some outcomes. Data suggest improved outcomes found in the assessment condition were not due to assessment reactivity. Although 3-month follow-up data were not obtained for the screened condition, data also provide support for the possibility that those in the intervention condition may undergo more sustainable long-term benefits compared to those in either the screened or assessment conditions.