Can brief intervention reduce alcohol intake among ICU survivors with history of hazardous alcohol use?

Recently published research paper compared the effectiveness of a brief intervention (BI) with usual care in reducing alcohol intake in intensive care unit (ICU) survivors with a history of hazardous alcohol use. The study was a randomized controlled trial where adult ICU patients with an Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score > 5 for women, or > 6 for men were randomized to either receive a BI or treatment as usual (TAU). The primary outcome was self-reported alcohol consumption during the preceding week at 6 and 12 months after randomization. Secondary outcomes were the change in AUDIT-C scores from baseline to 6 and 12 months, health-related quality of life, and mortality.

The results indicated that at 6 months, the median alcohol intake in the BI and TAU groups did not significantly differ. At 12 months, there was also no significant difference in alcohol intake between the two groups. Furthermore, the change in AUDIT-C scores from baseline to 6 and 12 months did not significantly differ between the BI and TAU groups. Additionally, the study found that both groups showed a considerable reduction in alcohol consumption, with some individuals becoming abstinent. There was no significant difference in mortality between the two groups. The trial was terminated early due to slow recruitment during the pandemic, resulting in an underpowered study to reject or confirm that a single BI early after critical illness is effective in reducing alcohol consumption compared to TAU.

The authors concluded that the study lacked the statistical power to confirm or reject the hypothesis that a BI early after ICU discharge is effective in reducing the amount of alcohol consumed compared to TAU. However, the results suggested that critical illness is a strong motivating factor for changing behavior, and supporting this motivation may reduce the negative health consequences of hazardous alcohol consumption in ICU survivors. Although the study had limitations such as early termination and high loss to follow-up rates, the findings highlighted the importance of further research to identify the optimal methods for reducing hazardous alcohol consumption in ICU survivors.

Key Points -

- The research paper conducted a randomized controlled trial comparing a brief intervention (BI) with usual care in reducing alcohol intake in intensive care unit (ICU) survivors with a history of hazardous alcohol use. Adult ICU patients with a high Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) score were randomized to receive either a BI or treatment as usual (TAU).

- The study found that at 6 and 12 months, there was no significant difference in alcohol intake between the BI and TAU groups. Additionally, the change in AUDIT-C scores from baseline to 6 and 12 months did not significantly differ between the two groups. Both groups showed a considerable reduction in alcohol consumption, with some individuals becoming abstinent, and there was no significant difference in mortality.

- The authors concluded that the study lacked the statistical power to confirm or reject the hypothesis that a BI early after ICU discharge is effective in reducing alcohol consumption compared to TAU. However, they suggested that critical illness is a strong motivating factor for changing behavior, and supporting this motivation may reduce the negative health consequences of hazardous alcohol consumption in ICU survivors. The study had limitations such as early termination and high loss to follow-up rates, highlighting the importance of further research in this area.

Reference –

Nissilä, E., Hynninen, M., Jalkanen, V. et al. The effectiveness of a brief intervention for intensive care unit patients with hazardous alcohol use: a randomized controlled trial. Crit Care 28, 145 (2024). https://doi.org/10.1186/s13054-024-04925-z