Dosage of booster phone calls following an SBIRT intervention in the emergency department for reducing substance use.

Brief Interventions (BIs) for problematic drug use in general medical settings, including in Emergency Departments (EDs), have shown disappointing results compared to those that target problematic alcohol use. Telephone booster calls may augment the impact of a BI delivered in the ED. The current study uses data from the National Drug Abuse Treatment Clinical Trials Network (CTN) Protocol CTN-0047, “Screening, Motivational Assessment, Referral, and Treatment in Emergency Departments (SMART-ED),” a multisite randomized clinical trial conducted in six EDs in the U.S. Researchers examine dose effects of telephone boosters (0, 1, or 2 calls completed) with non-treatment-seeking patients who were randomized to the BI-Booster condition and who endorsed problematic drug use during their ED visit (N=427). Primary outcomes were assessed at 3-, 6-, and 12-month follow-ups, which included past month use of the primary drug of choice, use of any drug, and heavy drinking. There were no significant differences among those completing 0, 1, or 2 booster calls on any of the three main outcomes at 3-, 6-, and 12-months post-BI in the ED. Patients who were older were significantly more likely to complete booster calls.

Conclusions: The parent SMART-ED study had found no benefit of BI or BI plus telephone calls over and above minimal screening. This secondary analysis of data from that study further indicates that the number of booster calls that participants completed in the BI-B condition, ranging from 0 to 2, was not associated with different drug use or heavy alcohol use outcomes. These findings raise questions about the clinical utility of booster phone calls following screening and BIs targeting heterogeneous drug use in the ED.

Related protocols: CTN-0047