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Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic rand...
Addiction, Volume: 117, Issue: 8, Pages: 2200 - 2214
Swansea University Authors:
Ceri Phillips, Rhys Pockett , Ian Russell
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DOI (Published version): 10.1111/add.15884
Abstract
Background and aimsAlcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost-effectiveness of ASBI compared with screening al...
Published in: | Addiction |
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ISSN: | 0965-2140 1360-0443 |
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Wiley
2022
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<?xml version="1.0"?><rfc1807><datestamp>2022-07-25T11:39:33.4444981</datestamp><bib-version>v2</bib-version><id>59564</id><entry>2022-03-09</entry><title>Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial)</title><swanseaauthors><author><sid>932c7a406ab4b6e4a881d422ca03c289</sid><firstname>Ceri</firstname><surname>Phillips</surname><name>Ceri Phillips</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>8a3882ebcc6a8fb3b2c13fc2ff716bf2</sid><ORCID>0000-0003-4135-7383</ORCID><firstname>Rhys</firstname><surname>Pockett</surname><name>Rhys Pockett</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>07f8ce1304fdfe94981330301c2b3977</sid><ORCID>0000-0002-0069-479X</ORCID><firstname>Ian</firstname><surname>Russell</surname><name>Ian Russell</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2022-03-09</date><deptcode>FGMHL</deptcode><abstract>Background and aimsAlcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost-effectiveness of ASBI compared with screening alone (SA) in high-risk adolescents.Design, Setting and ParticipantsMulti-centre, three-group, single-blind, individually randomized trial with follow-ups after 6 and 12 months in 10 ED settings in England. From October 2014 to May 2015 we screened 3327 adolescents aged 14 to 18 years, of whom 756 (22.7%) scored at least 3 on the Alcohol Use Disorders Identification Test: consumption (AUDIT-C) and consented to participate in this trial. Mean age was 16.1 years; 50.2% were female and 84.9% were white.InterventionsInterventions were personalized feedback and brief advice (PFBA), personalized feedback plus electronic brief intervention (eBI) and SA.MeasuresThe primary outcome was the weekly alcohol consumed in standard UK units (8 g ethanol) at 12 months post-randomization, derived from extended AUDIT-C. Economic outcomes included quality of life and service use, from perspectives of both the National Health Service and personal social services (NHS&PSS) and society.FindingsAt 12 months, mean weekly consumption was 2.99 [95% confidence interval (CI) = 2.38–3.70] standard units for the SA group, 3.56 (95% CI = 2.90, 4.32) for PFBA and 3.18 (95% CI = 2.50, 3.97) for eBI, showing no significant differences. The PFBA group consumed mean 0.57 (−0.36, 1.70) units more than SA; and eBIs consumed 0.19 (−0.71, 1.30) more. Bayes factors suggested lack of effectiveness explained non-significance. From the NHS&PSS perspective, economic analysis showed that PFBA and eBI were not cost-effective compared with SA: PFBA yielded incremental cost-effectiveness ratio of £6213 (−£736 843, £812 884), with the intervention having 54% probability of being cost-effective compared with SA at the £20 000 WTP threshold.ConclusionsIn emergency departments in England, neither personalized feedback and brief advice nor personalized feedback plus electronic brief intervention showed evidence of being effective or cost-effective when compared with screening alone in reducing alcohol consumption among adolescents.</abstract><type>Journal Article</type><journal>Addiction</journal><volume>117</volume><journalNumber>8</journalNumber><paginationStart>2200</paginationStart><paginationEnd>2214</paginationEnd><publisher>Wiley</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>0965-2140</issnPrint><issnElectronic>1360-0443</issnElectronic><keywords>Alcohol, Alcohol screening, Adolescent, High risk, Brief intervention, Electronic brief intervention, Emergency Department, Pragmatic randomised trial, Effectiveness, Cost-effectiveness</keywords><publishedDay>1</publishedDay><publishedMonth>8</publishedMonth><publishedYear>2022</publishedYear><publishedDate>2022-08-01</publishedDate><doi>10.1111/add.15884</doi><url/><notes/><college>COLLEGE NANME</college><department>Medicine, Health and Life Science - Faculty</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>FGMHL</DepartmentCode><institution>Swansea University</institution><apcterm>External research funder(s) paid the OA fee (includes OA grants disbursed by the Library)</apcterm><funders>National Institute for Health Research (NIHR) Programme Grant for Applied Research, Grant/Award Number: RP-PG-0609-10162</funders><projectreference/><lastEdited>2022-07-25T11:39:33.4444981</lastEdited><Created>2022-03-09T14:42:31.6419482</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care</level></path><authors><author><firstname>Paolo</firstname><surname>Deluca</surname><orcid>0000-0002-9511-7230</orcid><order>1</order></author><author><firstname>Simon</firstname><surname>Coulton</surname><order>2</order></author><author><firstname>Mohammed Fasihul</firstname><surname>Alam</surname><order>3</order></author><author><firstname>Sadie</firstname><surname>Boniface</surname><orcid>0000-0003-3492-6402</orcid><order>4</order></author><author><firstname>Kim</firstname><surname>Donoghue</surname><orcid>0000-0002-7316-1716</orcid><order>5</order></author><author><firstname>Eilish</firstname><surname>Gilvarry</surname><order>6</order></author><author><firstname>Eileen</firstname><surname>Kaner</surname><order>7</order></author><author><firstname>Ellen</firstname><surname>Lynch</surname><order>8</order></author><author><firstname>Ian</firstname><surname>Maconochie</surname><order>9</order></author><author><firstname>Paul</firstname><surname>McArdle</surname><order>10</order></author><author><firstname>Ruth</firstname><surname>McGovern</surname><order>11</order></author><author><firstname>Dorothy</firstname><surname>Newbury‐Birch</surname><order>12</order></author><author><firstname>Robert</firstname><surname>Patton</surname><order>13</order></author><author><firstname>Tracy</firstname><surname>Pellat‐Higgins</surname><order>14</order></author><author><firstname>Ceri</firstname><surname>Phillips</surname><order>15</order></author><author><firstname>Thomas</firstname><surname>Phillips</surname><order>16</order></author><author><firstname>Rhys</firstname><surname>Pockett</surname><orcid>0000-0003-4135-7383</orcid><order>17</order></author><author><firstname>Ian</firstname><surname>Russell</surname><orcid>0000-0002-0069-479X</orcid><order>18</order></author><author><firstname>John</firstname><surname>Strang</surname><orcid>0000-0002-5413-2725</orcid><order>19</order></author><author><firstname>Colin</firstname><surname>Drummond</surname><order>20</order></author></authors><documents><document><filename>59564__24264__c33b1637d6274ad29115f86c3a4d0b7d.pdf</filename><originalFilename>59564.pdf</originalFilename><uploaded>2022-06-09T13:56:22.3779413</uploaded><type>Output</type><contentLength>1732075</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© 2022 The Authors. 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2022-07-25T11:39:33.4444981 v2 59564 2022-03-09 Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) 932c7a406ab4b6e4a881d422ca03c289 Ceri Phillips Ceri Phillips true false 8a3882ebcc6a8fb3b2c13fc2ff716bf2 0000-0003-4135-7383 Rhys Pockett Rhys Pockett true false 07f8ce1304fdfe94981330301c2b3977 0000-0002-0069-479X Ian Russell Ian Russell true false 2022-03-09 FGMHL Background and aimsAlcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost-effectiveness of ASBI compared with screening alone (SA) in high-risk adolescents.Design, Setting and ParticipantsMulti-centre, three-group, single-blind, individually randomized trial with follow-ups after 6 and 12 months in 10 ED settings in England. From October 2014 to May 2015 we screened 3327 adolescents aged 14 to 18 years, of whom 756 (22.7%) scored at least 3 on the Alcohol Use Disorders Identification Test: consumption (AUDIT-C) and consented to participate in this trial. Mean age was 16.1 years; 50.2% were female and 84.9% were white.InterventionsInterventions were personalized feedback and brief advice (PFBA), personalized feedback plus electronic brief intervention (eBI) and SA.MeasuresThe primary outcome was the weekly alcohol consumed in standard UK units (8 g ethanol) at 12 months post-randomization, derived from extended AUDIT-C. Economic outcomes included quality of life and service use, from perspectives of both the National Health Service and personal social services (NHS&PSS) and society.FindingsAt 12 months, mean weekly consumption was 2.99 [95% confidence interval (CI) = 2.38–3.70] standard units for the SA group, 3.56 (95% CI = 2.90, 4.32) for PFBA and 3.18 (95% CI = 2.50, 3.97) for eBI, showing no significant differences. The PFBA group consumed mean 0.57 (−0.36, 1.70) units more than SA; and eBIs consumed 0.19 (−0.71, 1.30) more. Bayes factors suggested lack of effectiveness explained non-significance. From the NHS&PSS perspective, economic analysis showed that PFBA and eBI were not cost-effective compared with SA: PFBA yielded incremental cost-effectiveness ratio of £6213 (−£736 843, £812 884), with the intervention having 54% probability of being cost-effective compared with SA at the £20 000 WTP threshold.ConclusionsIn emergency departments in England, neither personalized feedback and brief advice nor personalized feedback plus electronic brief intervention showed evidence of being effective or cost-effective when compared with screening alone in reducing alcohol consumption among adolescents. Journal Article Addiction 117 8 2200 2214 Wiley 0965-2140 1360-0443 Alcohol, Alcohol screening, Adolescent, High risk, Brief intervention, Electronic brief intervention, Emergency Department, Pragmatic randomised trial, Effectiveness, Cost-effectiveness 1 8 2022 2022-08-01 10.1111/add.15884 COLLEGE NANME Medicine, Health and Life Science - Faculty COLLEGE CODE FGMHL Swansea University External research funder(s) paid the OA fee (includes OA grants disbursed by the Library) National Institute for Health Research (NIHR) Programme Grant for Applied Research, Grant/Award Number: RP-PG-0609-10162 2022-07-25T11:39:33.4444981 2022-03-09T14:42:31.6419482 Faculty of Medicine, Health and Life Sciences School of Health and Social Care Paolo Deluca 0000-0002-9511-7230 1 Simon Coulton 2 Mohammed Fasihul Alam 3 Sadie Boniface 0000-0003-3492-6402 4 Kim Donoghue 0000-0002-7316-1716 5 Eilish Gilvarry 6 Eileen Kaner 7 Ellen Lynch 8 Ian Maconochie 9 Paul McArdle 10 Ruth McGovern 11 Dorothy Newbury‐Birch 12 Robert Patton 13 Tracy Pellat‐Higgins 14 Ceri Phillips 15 Thomas Phillips 16 Rhys Pockett 0000-0003-4135-7383 17 Ian Russell 0000-0002-0069-479X 18 John Strang 0000-0002-5413-2725 19 Colin Drummond 20 59564__24264__c33b1637d6274ad29115f86c3a4d0b7d.pdf 59564.pdf 2022-06-09T13:56:22.3779413 Output 1732075 application/pdf Version of Record true © 2022 The Authors. This is an open access article under the terms of the Creative Commons Attribution License true eng http://creativecommons.org/licenses/by/4.0/ |
title |
Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
spellingShingle |
Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) Ceri Phillips Rhys Pockett Ian Russell |
title_short |
Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
title_full |
Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
title_fullStr |
Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
title_full_unstemmed |
Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
title_sort |
Effectiveness and cost‐effectiveness of face‐to‐face and electronic brief interventions versus screening alone to reduce alcohol consumption among high‐risk adolescents presenting to emergency departments: three‐arm pragmatic randomized trial (SIPS Junior high risk trial) |
author_id_str_mv |
932c7a406ab4b6e4a881d422ca03c289 8a3882ebcc6a8fb3b2c13fc2ff716bf2 07f8ce1304fdfe94981330301c2b3977 |
author_id_fullname_str_mv |
932c7a406ab4b6e4a881d422ca03c289_***_Ceri Phillips 8a3882ebcc6a8fb3b2c13fc2ff716bf2_***_Rhys Pockett 07f8ce1304fdfe94981330301c2b3977_***_Ian Russell |
author |
Ceri Phillips Rhys Pockett Ian Russell |
author2 |
Paolo Deluca Simon Coulton Mohammed Fasihul Alam Sadie Boniface Kim Donoghue Eilish Gilvarry Eileen Kaner Ellen Lynch Ian Maconochie Paul McArdle Ruth McGovern Dorothy Newbury‐Birch Robert Patton Tracy Pellat‐Higgins Ceri Phillips Thomas Phillips Rhys Pockett Ian Russell John Strang Colin Drummond |
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Addiction |
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117 |
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8 |
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2022 |
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Swansea University |
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0965-2140 1360-0443 |
doi_str_mv |
10.1111/add.15884 |
publisher |
Wiley |
college_str |
Faculty of Medicine, Health and Life Sciences |
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facultyofmedicinehealthandlifesciences |
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Faculty of Medicine, Health and Life Sciences |
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facultyofmedicinehealthandlifesciences |
hierarchy_parent_title |
Faculty of Medicine, Health and Life Sciences |
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School of Health and Social Care{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care |
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description |
Background and aimsAlcohol use increases throughout adolescence. Emergency department (ED) attendance is an opportunity for alcohol screening and brief intervention (ASBI), which is effective for adults. This trial evaluated the effectiveness and cost-effectiveness of ASBI compared with screening alone (SA) in high-risk adolescents.Design, Setting and ParticipantsMulti-centre, three-group, single-blind, individually randomized trial with follow-ups after 6 and 12 months in 10 ED settings in England. From October 2014 to May 2015 we screened 3327 adolescents aged 14 to 18 years, of whom 756 (22.7%) scored at least 3 on the Alcohol Use Disorders Identification Test: consumption (AUDIT-C) and consented to participate in this trial. Mean age was 16.1 years; 50.2% were female and 84.9% were white.InterventionsInterventions were personalized feedback and brief advice (PFBA), personalized feedback plus electronic brief intervention (eBI) and SA.MeasuresThe primary outcome was the weekly alcohol consumed in standard UK units (8 g ethanol) at 12 months post-randomization, derived from extended AUDIT-C. Economic outcomes included quality of life and service use, from perspectives of both the National Health Service and personal social services (NHS&PSS) and society.FindingsAt 12 months, mean weekly consumption was 2.99 [95% confidence interval (CI) = 2.38–3.70] standard units for the SA group, 3.56 (95% CI = 2.90, 4.32) for PFBA and 3.18 (95% CI = 2.50, 3.97) for eBI, showing no significant differences. The PFBA group consumed mean 0.57 (−0.36, 1.70) units more than SA; and eBIs consumed 0.19 (−0.71, 1.30) more. Bayes factors suggested lack of effectiveness explained non-significance. From the NHS&PSS perspective, economic analysis showed that PFBA and eBI were not cost-effective compared with SA: PFBA yielded incremental cost-effectiveness ratio of £6213 (−£736 843, £812 884), with the intervention having 54% probability of being cost-effective compared with SA at the £20 000 WTP threshold.ConclusionsIn emergency departments in England, neither personalized feedback and brief advice nor personalized feedback plus electronic brief intervention showed evidence of being effective or cost-effective when compared with screening alone in reducing alcohol consumption among adolescents. |
published_date |
2022-08-01T04:16:59Z |
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1763754135061004288 |
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11.021648 |