Preoperative alcohol interventions for elective surgical patients: Results from a randomized pilot trial

• Published in: Surgery Vol. 172; no. 6; pp. 1673 - 1681
• Main Authors: Fernandez, Anne C., Chapman, Lyndsay, Ren, Tom Y., Baxley, Catherine, Hallway, Alexander K., Tang, Michael J., Waljee, Jennifer F., Friedmann, Peter D., Mello, Michael, Borsari, Brian, Blow, Frederic
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2022
• Subjects: Adolescent; Adult; Aged; Alcohol Drinking - prevention & control; Alcoholism; Elective Surgical Procedures; Humans; Middle Aged; Motivational Interviewing - methods; Pilot Projects; Young Adult
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2022.09.012

High-risk alcohol use is a common surgical risk factor. Stopping or reducing alcohol use in the weeks before and after surgery could improve surgical health and outcomes. The purpose of this study was to evaluate the feasibility and acceptability of 2 interventions that address high-risk alcohol use in the context of surgery. Participants included patients scheduled for elective surgeries at an academic health system in the Midwestern United States. Recruitment took place by phone and text. Participants were included if they were 18 to 75 years old, scheduled for elective surgeries, and scored ≥5 on the Alcohol Use Disorders Identification Test–Consumption Tool. Participants were randomized to either a low-intensity intervention, brief advice (10-minute phone-based psychoeducation plus feedback session), or a higher-intensity intervention, health coaching (two 45-minute sessions including education, feedback, motivational interviewing, and goal setting). Assessments took place at baseline and at 1-month and 4-month follow-ups. Alcohol biomarkers were collected the day of surgery. The final study sample included (n = 51) participants randomized to brief advice and health coaching conditions. Participants in both conditions rated interventions as satisfactory and personally relevant. Trial retention was high (86.3%) at 4 months. Attrition was significantly higher in brief advice (n = 6) relative to health coaching (n = 1). Average weekly alcohol use decreased 50% to 60% between baseline and follow-ups in both conditions. Biomarkers corroborated self-report. The trial demonstrated intervention feasibility and acceptability. Alcohol use changed in expected directions. The next steps include a randomized controlled trial to test intervention efficacy in reducing alcohol use and surgical complications.