Brief interventions to prevent recurrence and alcohol-related problems in young adults admitted to the emergency ward following an alcohol-related event: a systematic review.

BACKGROUND Brief interventions addressing harmful alcohol use in adults admitted to emergency wards have been shown to be effective. The evidence in relation to interventions aimed at adolescents is less conclusive. Young adults share developmental characteristics with adolescents, while receiving care in adult services. We conducted a systematic review to assess the effectiveness of interventions to reduce the recurrence of alcohol-related events and their consequences in young adults (18-24 years) admitted to an emergency ward following alcohol intoxication. METHODS We followed PRISMA guidelines to conduct this review. We searched Medline, Embase, Cochrane and PsychINFO, until March 2014. We included randomised trials of brief interventions aimed at young adults admitted to an emergency ward following an alcohol-related event. Two investigators independently selected, analysed, rated and summarised the evidence from relevant studies. RESULTS Four trials (n=618) were included, comparing a brief motivational interview with usual care (2 trials), personalised feedback or an educational brochure. In two studies, motivational interview was significantly associated with a reduction in alcohol-use while two studies showed no effect attributable to the intervention. Successful interventions were either delivered at a distance from the event or included booster sessions. Motivational interview favoured a reduction in alcohol-related problems in all but one study. Benefits were sustained over 12 months. CONCLUSIONS The evidence is inconclusive, but the most effective interventions include at least one therapeutic contact several days after the event. Further research should provide more guidance about effective interventions in this age-group as well as about ways to favour delayed attendance for treatment. The potential role of parents or peers in supporting treatment also warrants further attention.