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Reduction of Alcohol Consumption by Brief Alcohol Intervention in Primary Care
Systematic Review and Meta-analysis
Nicolas Bertholet, MD;
Jean-Bernard Daeppen, MD;
Vincent Wietlisbach, BA ;
Michael Fleming, MD;
Bernard Burnand, MD, MPH
Arch Intern Med. 2005;165:986-995.
Background Numerous trials of the efficacy of brief alcohol intervention have been conducted in various settings among individuals with a wide range of alcohol disorders. Nevertheless, the efficacy of the intervention is likely to be influenced by the context. We evaluated the evidence of efficacy of brief alcohol interventions aimed at reducing long-term alcohol use and related harm in individuals attending primary care facilities but not seeking help for alcohol-related problems.
Methods We selected randomized trials reporting at least 1 outcome related to alcohol consumption conducted in outpatients who were actively attending primary care centers or seeing providers. Data sources were the Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, ISI Web of Science, ETOH database, and bibliographies of retrieved references and previous reviews. Study selection and data abstraction were performed independently and in duplicate. We assessed the validity of the studies and performed a meta-analysis of studies reporting alcohol consumption at 6 or 12 months of follow-up.
Results We examined 19 trials that included 5639 individuals. Seventeen trials reported a measure of alcohol consumption, of which 8 reported a significant effect of intervention. The adjusted intention-to-treat analysis showed a mean pooled difference of –38 g of ethanol (approximately 4 drinks) per week (95% confidence interval, –51 to –24g/wk) in favor of the brief alcohol intervention group. Evidence of other outcome measures was inconclusive.
Conclusion Focusing on patients in primary care, our systematic review and meta-analysis indicated that brief alcohol intervention is effective in reducing alcohol consumption at 6 and 12 months.
Author Affiliations: Alcohol Treatment Center (Drs Bertholet and Daeppen) and Clinical Epidemiology Center (Drs Bertholet and Burnand), University Hospital, Lausanne, Switzerland; Health Care Evaluation Unit, Institute of Social and Preventive Medicine, University of Lausanne (Mr Wietlisbach and Dr Burnand); and Department of Family Medicine, University of Wisconsin–Madison Medical School (Dr Fleming).
Deceased.
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