How can we improve trials assessing the effectiveness of Screening, Brief Intervention, and Referral to Treatment (SBIRT) for substance use? Methodological issues encountered during a systematic review

Article type
Authors
Young M1, Stevens A2, Galipeau J2, Pirie T1, Garritty C2, Singh K2, Yazdi F2, Golfam M2, Pratt M2, Turner L2, Porath-Waller A1, Grimshaw JM3, Moher D3
1Canadian Centre on Substance Abuse, Canada
2Ottawa Hospital Research Institute, Canada
3Ottawa Hospital Research Institute and University of Ottawa, Canada
Abstract
Category: Other topics.

Background: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a comprehensive, integrated public health approach to providing early intervention and treatment services for individuals at risk of substance use-related harms. Evidence exists to support the use of SBIRT for alcohol use, but no systematic review has been done for other substances. We conducted a systematic review on the effectiveness of screening and brief interventions as part of the SBIRT model for reducing the non-medical use of psychoactive substances. During our assessment of studies, we uncovered methodological and reporting issues in this literature.

Objectives: We will present the methodological and reporting issues we identified in the literature assessing screening and brief interventions for substance use, as encountered during our systematic review. We will offer possible solutions to overcome some issues.

Methods: We included randomized controlled trials opportunistically screening adolescents or adults and then providing a one-to-one, verbal brief intervention to those at risk of substance use harms. The non-medical use of psychoactive substances were of interest, excluding alcohol, nicotine, and caffeine. Interventions were comprised of four or less sessions and were compared with no/delayed intervention or provision of information only. Methodological and reporting issues were encountered during the process of conducting the review.

Results: Few studies met the inclusion criteria. Methodological issues in the literature relate to the consent process, the screening procedure (i.e., whether opportunistic), inconsistent measurement and reporting of outcomes, and trial design. We will discuss possible solutions for some of these issues when designing future studies in this area.

Conclusions: Important methodological limitations exist in the SBIRT literature, some of which could be overcome with the design of future studies. This presentation will be relevant to those conducting methodological assessments of this or related literature and those involved in trial design in this area.