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The Cochrane 2018 Review on Brief Interventions in Primary Care for Hazardous and Harmful Alcohol Consumption: A Distillation for Clinicians and Policy Makers

Lookup NU author(s): Fiona Beyer, Dr Colin Muirhead, Professor Eileen Kaner

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Abstract

© The Author(s) 2019. Medical Council on Alcohol and Oxford University Press. All rights reserved.AIMS: An updated Cochrane systematic review assessed effectiveness of screening and brief intervention to reduce hazardous or harmful alcohol consumption in general practice or emergency care settings. This paper summarises the implications of the review for clinicians. METHODS: Cochrane methods were followed. Reporting accords with PRISMA guidance. We searched multiple resources to September 2017, seeking randomised controlled trials of brief interventions to reduce hazardous or harmful alcohol consumption in people attending general practice, emergency care or other primary care settings for reasons other than alcohol treatment. Brief intervention was defined as a conversation comprising five or fewer sessions of brief advice or brief lifestyle counselling and a total duration of less than 60 min. Our primary outcome was alcohol consumption, measured as or convertible to grams per week. We conducted meta-analyses to assess change in consumption, and subgroup analyses to explore the impact of participant and intervention characteristics. RESULTS: We included 69 studies, of which 42 were added for this update. Most studies (88%) compared brief intervention to control. The primary meta-analysis included 34 studies and provided moderate-quality evidence that brief intervention reduced consumption compared to control after one year (mean difference -20 g/wk, 95% confidence interval -28 to -12). Subgroup analysis showed a similar effect for men and women. CONCLUSIONS: Brief interventions can reduce harmful and hazardous alcohol consumption in men and women. Short, advice-based interventions may be as effective as extended, counselling-based interventions for patients with harmful levels of alcohol use who are presenting for the first time in a primary care setting.


Publication metadata

Author(s): Beyer FR, Campbell F, Bertholet N, Daeppen JB, Saunders JB, Pienaar ED, Muirhead CR, Kaner EFS

Publication type: Article

Publication status: Published

Journal: Alcohol and Alcoholism

Year: 2019

Volume: 54

Issue: 4

Pages: 417-427

Print publication date: 01/07/2019

Online publication date: 07/05/2019

Acceptance date: 23/04/2019

ISSN (print): 0735-0414

ISSN (electronic): 1464-3502

Publisher: Oxford University Press

URL: https://doi.org/10.1093/alcalc/agz035

DOI: 10.1093/alcalc/agz035

PubMed id: 31062859


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