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Brief alcohol intervention in alcohol involved facial fracture patients—a survey of patient attitudes to screening and intervention

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Abstract

Purpose

Alcohol intoxication is an important contributor to traumatic facial injuries. The period following injuries afford clinicians a useful window of opportunity to provide alcohol screening and brief intervention (SBI) which may affect changes in patients’ future drinking behaviour. Although SBI has been reported to decrease at risk drinking and potentially trauma recurrence, it is not routinely utilised in most clinical settings in the world. This study aims to assess utilisation of, as well as patients’ knowledge and attitude towards SBI in the management of patients presenting with alcohol-related facial fractures.

Methods

Twenty consecutive patients who presented to Western Health with facial fractures who met selection criteria were offered an alcohol screening and survey questionnaire.

Results

Ninety percent of patients were male and 50% were aged between 19 and 34. ASSIST score showed 65% were in the moderate risk category; 75% reported this was their first admission with alcohol related trauma. Although 75% acknowledged alcohol as a main cause of injury, only 40% agreed they drink too much. Forty-four percent felt that talking to a healthcare worker might help and 33% would consider accepting help. Forty-seven percent felt reading materials would be helpful in changing future drinking habits. Whilst 63% would like to know safe drinking limit, only 45% would like to have a discussion about alcohol-related harms.

Conclusions

Most patients presented in this survey were in moderate risk category who are amenable to behavioural change with provision of SBI. However, there is resistance to implementation of this intervention due to lack of knowledge, self-awareness and willingness to change. Nonetheless, patients are prepared to accept advice from clinicians and some formats of intervention. It is important to formulate a simple screening questionnaire and intervention strategy that are easy to administer to affect positive changes in patients with harmful drinking behaviours.

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References

  1. Anderson P, Baumberg B. Alcohol in Europe A Public Health Perspective. http://mail.google.com/mail/u/0/#inbox/1597c265852bcaaf. Accessed 14 January 2017

  2. Lee KH (2008) Epidemiology of mandibular fractures in a tertiary trauma centre. Emerg Med J 25:565–568

    Article  CAS  PubMed  Google Scholar 

  3. Laverick S, Patel N, Jones DC (2008) Maxillofacial trauma and the role of alcohol. Br J Oral Maxillofac Surg 46:542–546

    Article  CAS  PubMed  Google Scholar 

  4. O’Meara C, Witherspoon R, Hapangama N, Hyam DM (2012) Alcohol and interpersonal violence may increase the severity of facial fracture. Br J Oral Maxillofac Surg 50:36–40

    Article  PubMed  Google Scholar 

  5. Murphy DA, Shetty V, Der-Martirosian C, Herbeck DM, Resell J, Urata M, Yamashita DD (2009) Factors associated with Orofacial injury and willingness to participate in interventions among adolescents treated in trauma centers. J Oral Maxillofac Surg 67:2627–2635

    Article  PubMed  PubMed Central  Google Scholar 

  6. Sims DW, Bivins BA, Obeid FN et al (1989) Urban trauma: a chronic recurrent disease. J Trauma 29:940–947

    Article  CAS  PubMed  Google Scholar 

  7. Smith RS, Fry WR, Morabito DJ et al (1992) Recidivism in an urban trauma center. Arch Surg 127:668–670

    Article  CAS  PubMed  Google Scholar 

  8. Murphy DA, Shetty V, Zigler C et al (2010) Willingness of facial injury patients to change casual substance using behaviors. Sust Abus 31:35–42

    Article  Google Scholar 

  9. The American College of Surgeons Committee on Trauma (ACS) Alcohol Screening and Brief Intervention for Trauma Patient (2005). http://www.facs.org/~/media/files/quality%20programs/trauma/publications/sbirtguide.ashx. Accessed 14 January 2017

  10. Dawson DA, Grant BF, Stinson FS et al (2004) Toward the attainment of low-risk drinking goals: a 10-year progress report. Alcohol Clin Exp Res 28:1371–1378

    Article  PubMed  Google Scholar 

  11. Field CA, Caetano R, Harris TR, Frankowski R, Roudsari B (2010) Ethnic differences in drinking outcomes following a brief alcohol intervention in the trauma care setting. Addiction 105:62–73

    Article  PubMed  Google Scholar 

  12. Whitlock EP, Polen MR, Green CA, Orleans T, Klein J (2004) Behavioural counselling interventions in primary care to reduce risky/harmful alcohol use in adults: a summary of the evidence for the U.S. preventative services task force. Ann Intern Med 140:557–568

    Article  PubMed  Google Scholar 

  13. Dill PL, Wells-Parker E, Soderstrom CA (2004) The emergency care setting for screening and intervention for alcohol use problems among injured and high-risk drivers: a review. Traffic Injury Prevent 5:278–291

    Article  Google Scholar 

  14. Schermer CR, Moyers TB et al (2006) Trauma centre brief interventions for alcohol disorders decreased subsequent driving under the influence arrests. J Trauma 60:29–34

    Article  PubMed  Google Scholar 

  15. Johnston BD, Rivara FP, Droesch RM, Dunn C, Copass MK (2002) Behavior change counseling in the emergency department to reduce injury risk: a randomized controlled trial. Pediatrics 110:267–274

    Article  PubMed  Google Scholar 

  16. Dinn-Zarr TB, Goss CW, Heitman E, Roberts IG, DiGuiseppi C (2004) Interventions for preventing injuries in problem drinkers. Cochrane Database Syst Rev Issue 3(Art No: CD001857)

  17. Havard A, Shakeshift A, Sanson-Fisher R (2008) Systematic review and meta-analysis of strategies targeting alcohol problems in emergency departments: interventions reduce alcohol-related injuries. Addiction 103:368–376

    Article  PubMed  Google Scholar 

  18. Terrell F, Zatzick DF, Jurkovich GJ et al (2008) Nationwide survey of alcohol screening and brief intervention practices at US level I trauma centers. J Am Coll Surg 207(5):630–638

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gmel G, Gaume J, Bertholet N, Daeppen JB (2012) Brief alcohol intervention as pragmatic intervention: who is voluntarily taking an offered intervention? Alcohol 46(6):551–558

    Article  PubMed  Google Scholar 

  20. Bertholet N, Daeppen JB, Wietlisbach V, Fleming M, Burnard B (2005) Reduction of alcohol consumption by brief alcohol intervention in primary care: systematic review and meta-analysis. Arch Intern Med 165:986–995

    Article  PubMed  Google Scholar 

  21. Gentiello LM, Ebel BE et al (2005) Alcohol interventions for trauma patients treated in emergency departments and hospitals: a cost-benefit analysis. Ann Sug 241(4):541–555

    Article  Google Scholar 

  22. Newcombe DAL, Humeniuk RE, Ali R (2005) Validation of the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): report of results from the Australian site. Drug Alcohol Rev 24:217–226

    Article  PubMed  Google Scholar 

  23. Bien TH, Miller WR, Tonigan JS (1993) Brief interventions for alcohol problems: a review. Addiction 88:315–336

    Article  CAS  PubMed  Google Scholar 

  24. Apodaca T, Miller W (2003) A meta-analysis of the effectiveness of bibliotherapy for alcohol problems. J Clin Psychol 59:289–304

    Article  PubMed  Google Scholar 

  25. Karlsson A, Johansson K, Nordqvist C, Bendtsen P (2005) Feasibility of a computerized alcohol screening and personalised written advice in the ED: opportunities and obstacles. Accid Emerg Nurs 13:44–53

    Article  PubMed  Google Scholar 

  26. Lee KH, Bobinskas AM, Sun J (2015) Addressing alcohol-related harms within maxillofacial trauma practice. J Oral Maxillofac Surg 73:314.e1–314.e6

    Article  Google Scholar 

  27. Gentilello LM, Donovan DM, Dunn CW et al (1995) Alcohol intervention in trauma centers. Current practice and future directions. JAMA 274:1043–1048

    Article  CAS  PubMed  Google Scholar 

  28. Hingson R, Mangione T, Meyers A et al (1982) Seeking help for drinking problems; a study in the Boston metropolitan area. J Stud Alcohol 43:273–288

    Article  CAS  PubMed  Google Scholar 

  29. Grant BF (1996) Towards an alcohol treating model: a comparison of treated and untreated respondents with DSM-IV alcohol use disorders in the general population. Alcohol Clin Exp Res 20:372–378

    Article  CAS  PubMed  Google Scholar 

  30. van Duijvenbode N, Didden R, Korzilius HPLM, Engels RCME (2016) The role of executive control and readiness to change in problematic drinkers with mild to borderline intellectual disability. J Appl Res Intellect Disabil. doi:10.1111/jar.12280

    PubMed  Google Scholar 

  31. Hajek P, Taylor TZ, Mills P (2002) Brief intervention during hospital admission to help patients to give up smoking after myocardial infarction and bypass surgery: randomised controlled trial. BMJ 324(7329):87–89

    Article  PubMed  PubMed Central  Google Scholar 

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Authors

Corresponding author

Correspondence to Kai H Lee.

Ethics declarations

This study was granted ethics approval from the Western Health Low Risk Human Research Ethics Panel, Office for Research. Informed consent was obtained from all participants in this study.

Funding

This study has not received any funding.

Conflict of interest

The authors declare that they have no conflict of interest.

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Lee, K.H., Dastaran, M. & Chandu, A. Brief alcohol intervention in alcohol involved facial fracture patients—a survey of patient attitudes to screening and intervention. Oral Maxillofac Surg 21, 219–226 (2017). https://doi.org/10.1007/s10006-017-0621-6

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  • DOI: https://doi.org/10.1007/s10006-017-0621-6

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