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PW 2832 Evaluation of a substance use screening, brief intervention and referral to treatment (SBIRT) service for injured and non-injured patients in south african emergency centres
  1. Claire van der Westhuizen1,
  2. Megan Malan1,
  3. Tracey Naledi2,
  4. Marinda Roelofse2,
  5. Bronwyn Myers3,
  6. Dan Stein1,3,
  7. Katherine Sorsdahl1
  1. 1University of Cape Town, South Africa
  2. 2Western Cape Department of Health, South Africa
  3. 3South African Medical Research Council


Problem substance use makes a significant contribution to the burden of injuries and noncommunicable diseases in South Africa. In 2012, the Western Cape Department of Health funded a randomised controlled trial of substance use SBIRT in emergency centres (ECs). Based on the promising results, the programme was implemented in 2016 in three ECs, offering motivational interviewing-based counselling delivered at the acute EC visit by lay counsellors.

This study utilised data from a novel EC SBIRT service (1 August 2016 – 31 July 2017) and compared the characteristics, process and substance use outcome data for injured and non-injured patients. A screening questionnaire was administered to less seriously ill or injured adult patients, and those scoring at moderate-high risk on the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were eligible and received a motivational-interviewing-based session. Data collected included sociodemographics, presenting complaint, substance use days and the ASSIST. A three-month follow-up phone call was conducted to evaluate substance use in a small sample of service users. Process data was collected on the numbers of: patients screened, eligible patients, and sessions given.

In total, 13 136 patients were screened. Over half were male, the mean age was 37 years and 43% presented with an injury. Of the non-injured patients, 23% met criteria for problem substance use, compared to 56% of injured patients. Of the eligible patients, 74% were male and 83% received a counselling session. At three-month follow-up there was a significant reduction in substance use days for all patients and injured patients’ alcohol use scores decreased by 6.4 points, compared to 4.7 in the non-injured patients.

This EC SBIRT service delivered a substance use intervention to over 80% of eligible patients. Injured patients were more likely to report problem substance use, and showed a greater decrease in substance use scores.

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