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Using the Cardiff model to reduce late-night alcohol-related presentations in regional Australia
Tim Baker1,2, Nicholas Taylor3,4, Kate Kloot2,5
1Centre for Rural Emergency Medicine, Faculty of Health, Deakin University, Warrnambool, Victoria, Australia.
Insights
The Cardiff model, a data-sharing approach, showed a small but significant reduction in injury presentations during high-alcohol hours in a regional emergency department. This intervention shows promise for reducing alcohol-related harm.
Area of Science:
- Public Health
- Emergency Medicine
- Alcohol Harm Reduction
Background:
- The Cardiff model is a data-sharing strategy designed to decrease intoxicated patients in emergency departments (EDs).
- Its efficacy in rural or regional settings remained untested prior to this study.
Purpose of the Study:
- To evaluate if the Cardiff model could reduce alcohol-associated emergency department (ED) presentations during high-alcohol hours (HAH) in a regional ED.
- To assess the impact of sharing ED-collected alcohol consumption data with local authorities.
Main Methods:
- Triage nurses collected data on alcohol consumption, purchase location, and last drink location from patients over 18.
- Aggregated, deidentified data on the top five alcohol venues were shared quarterly with police, licensing authorities, and local government.
- Interrupted time series (ITS) analyses were employed to determine the intervention's effect on monthly injury and alcohol-related ED presentations.
Main Results:
- ITS models indicated a significant gradual decrease in the monthly rate of injury attendances during high-alcohol hours (p=0.044).
- No other statistically significant results were observed for other measured outcomes.
Conclusions:
- Sharing last drink data from EDs with a violence prevention committee was associated with a modest but significant reduction in injury presentations.
- The Cardiff model demonstrates potential as an intervention to mitigate alcohol-related harm in regional emergency settings.
Introduction:
The Cardiff model is a data sharing approach that aims to reduce the volume of intoxicated patients in emergency departments (EDs). This approach has not been tested in a rural setting.
Objective:
This study assessed whether this approach would reduce the number of alcohol-associated presentations during high-alcohol hours (HAH) in a regional ED.
Design:
From July 2017, people over the age of 18 attending the ED were asked by the triage nurse (1) whether they had consumed alcohol in the past 12 h, (2) their typical alcohol consumption level, (3) the location where most alcohol was purchased and (4) the location of the last drink. From April 2018, quarterly letters were sent to the top five venues reported within the ED. Deidentified, aggregated data were shared with local police, licensing authorities and local government, identifying the top five venues reported in the ED and providing a summary of alcohol-related attendances to the ED. Interrupted time series analyses were used to estimate the influence of the intervention on monthly injury and alcohol-related ED presentations.
Findings:
ITS models found that there was a significant gradual decrease in the monthly rate of injury attendances during HAH (Coefficient = -0.004, p = 0.044). No other significant results were found.
Discussion:
Our study found that sharing last drinks data collected in the ED with a local violence prevention committee was associated with a small, but significant reduction in the rate of injury presentations compared with all ED presentations.
Conclusion:
This intervention continues to have promise for reducing alcohol-related harm.
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