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Tackling Binge Drinking With Text Messages

Tackling Binge Drinking With Text Messages

Each year, more than 50,000 adults between the ages of 18 and 24 visit EDs, and about half have hazardous alcohol use patterns. “Alcohol is a leading preventable cause of mortality for young adults,” says Brian Suffoletto, MD, MS. The ED provides a unique setting to screen young adults for drinking problems because emergency physicians may be able to engage them in participating in interventions to reduce future use. The key, however, is to determine patients’ preferred mode of communication. Text messaging is a promising modality that could help clinicians effectively deliver brief interventions for alcohol use, especially among younger adults. Dr. Suffoletto says it is important to offer clinicians an alternative to lengthy in-person interviews and counseling with patients because these options are often not possible in the short time that is available during clinical encounters. About 95% of young adults own a mobile phone, and 97% of them use short message service (SMS), either sending or receiving an average of 50 texts per day. In previous research, SMS has been used to help with many young adult health issues, including diabetes, asthma, and cigarette smoking. However, few analyses have explored the effect of an SMS intervention to reduce alcohol use among young adults. Help Is Only a Text Away Dr. Suffoletto says that in some respects, a mobile program that interacts with people over time in their natural environment makes more sense when supporting behavior change. “A text message-based intervention can reach young adults in an environment where they’re making drinking choices,” he says. “This allows us to connect with patients when the issue can be addressed...
ED Return Visits: The Patient Perspective

ED Return Visits: The Patient Perspective

Reducing “unnecessary” use of the hospital has become an important initiative nationwide, but little is known about the patients who repeatedly seek care in the ED within a short timeframe. Studies have shown that about one-third of all acute care visits in the United States and half of hospital admissions originate in the ED. However, it is unclear how repeat ED utilization fits into the overall conversation about hospital readmissions. “Using patients’ perspectives regarding their reasons for returning to the ED may help inform future initiatives that aim to reduce recurrent utilization,” says Kristin L. Rising, MD, MS. A Look at Patient Perspectives In a study published in the Annals of Emergency Medicine, Dr. Rising and colleagues sought to describe the personal experiences and challenges faced by patients transitioning home after an ED discharge. The study group conducted 60 in-person interviews with patients who returned to the ED within 9 days of discharge. “The primary reason patients returned to the ED was fear or uncertainty about their ongoing medical symptoms,” Dr. Rising says. “Patients who returned to the ED within a few days of discharge did so because they believed their symptoms were too severe to wait until they could schedule an appointment or because they were instructed to return to the ED by outpatient providers they contacted.” Other prominent themes also emerged regarding patients’ limited use of outpatient care. Most patients had primary care physicians, but few visited them before returning to the ED. When study participants were asked about seeking follow-up care in an outpatient clinic instead of the ED, many reported that clinics lacked the resources...
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