Brief Intervention in Primary Care Can Reduce Problem Drinking

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NEW YORK (Reuters Health) Apr 25 - A brief intervention, delivered by a physician or nurse in a primary care setting, can lead to a reduction in excessive alcohol consumption among heavy drinkers. The finding comes from an analysis of pooled data from published studies, reported in the Cochrane Database of Systematic Reviews, second issue of 2007, published online April 18.

"We know that one in five patients attending primary care may be drinking at a level that can have a negative impact on their health or well-being," first author Dr. Eileen F. S. Kaner told Reuters Health. "The evidence on brief alcohol interventions has clear application for clinicians in their day-to-day practice and should be implemented in order to help their patients reduce their level of risk or harm due to alcohol."

Dr. Kaner, a senior lecturer in public health at Newcastle University in England, and her colleagues conducted a meta-analysis of 21 randomized controlled trials involving a total of 7,286 participants presenting to primary care not specifically for alcohol treatment. These individuals received either brief alcohol interventions within the time frame of a standard consultation -- 5 to 15 minutes for a general physician, longer for a nurse -- or no alcohol intervention.

The subjects had a mean age of 42 years and drank an average of 320 grams of alcohol per week (over 30 standard drinks). About 70% of subjects were men.

Participants who received brief alcohol "talks" reduced the amount of alcohol they consumed per week by 41 grams, which equates to 4 to 5 drinks, Dr. Kaner and colleagues report. "These results were robust," they say, noting that several sensitivity analyses were performed and all yielded similar results.

The impact of brief alcohol interventions in primary care "is strongest for men," Dr. Kaner said, noting that men who received the intervention reduced their weekly alcohol intake by an average of 57 grams. The benefit is less clear for women, "since fewer studies have focused on female heavy drinkers," Dr. Kaner noted.

Summing up, Dr. Kaner said: "There is now a large evidence base that consistently reports positive effects of brief alcohol intervention." Future trials should focus on women and on delineating the most effective components of intervention, she and colleagues conclude in their report.

Cochrane Database Syst Rev 2007;2.

Source: http://www.medscape.com/viewarticle/555681?src=mp