A comparison of the efficacy of brief interventions to reduce hazardous and harmful alcohol consumption between European and non‐European countries: a systematic review and meta‐analysis of randomized controlled trials

Elzerbi, Catherine; Donoghue, Kim; Drummond, Colin

doi:10.1111/add.12960

Cited by 47 publications

(55 citation statements)

References 72 publications

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“…Similarly, older men are more likely to drink daily and suffer more chronic health consequences. The prevalence of male participants, up to 79%, in the included studies reflects the higher proportion of men in the at‐risk drinking population and their overrepresentation in alcohol ED studies . This is of relevance as variable treatment effects across different patients have been observed in a number of studies …”

Section: Discussionmentioning

confidence: 97%

Review article: Effectiveness of ultra‐brief interventions in the emergency department to reduce alcohol consumption: A systematic review

McGinnes

Hutton

Weiland

et al. 2016

Emerg Medicine Australasia

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To assess the effectiveness of ultra-brief interventions (ultra-BI) or technology-involved preventive measures in the ED to reduce alcohol harm and risky drinking. Medline, Embase, PsycINFO, CINAHL and EBM reviews were searched for articles published between 1996 and 2015. Randomised controlled trials and quasi-randomised trials, which compared an ultra-BI with screening, standard care or minimal intervention for adults and adolescents at risk for alcohol-related harm presenting to an ED, were included. Outcomes of interest were frequency of alcohol consumption, quantity of alcohol consumed, binge drinking and ED representation. Thirteen studies (nine single centre and four multicentre) were included. Six studies showed a significant reduction in the quantity consumed with intermediate effect size at 3 months (d = -0.40) and small effect size at 12 months (d = -0.15). Two studies showed a significant reduction in binge drinking with small effect size at 3 months (d = -0.12) and 12 months (d = -0.09). No studies showed an effect on frequency of alcohol consumption or ED representation. Heterogeneity in study design, definition of risky, harmful or hazardous alcohol use, intervention types, outcomes, outcome timeframes and outcome measures prevented the performance of quantitative meta-analysis. Despite its limited effectiveness in reducing alcohol use in the short-term, with the large number of people attending EDs with risky drinking, the use of an effective ultra-BI would have the potential to have a measurable population effect.

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Section: Discussionmentioning

confidence: 97%

Review article: Effectiveness of ultra‐brief interventions in the emergency department to reduce alcohol consumption: A systematic review

McGinnes

Hutton

Weiland

et al. 2016

Emerg Medicine Australasia

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“…Current clinical guidelines for alcohol use disorders33 recommend that trained professionals in the health and social care sectors should routinely screen patients for harmful drinking and offer affected individuals structured brief advice to reduce their alcohol consumption. The efficacy of such brief interventions has been recently confirmed in a systematic review 34. Nonexperimental data have further suggested more comprehensive interventions aimed at reducing violence rates among individuals admitted to emergency departments for injury due to exposure to violence by closely following up high-risk patients with a multidisciplinary team that includes physicians, nurses, and social workers 35.…”

Section: Discussionmentioning

confidence: 96%

Triggers for Violent Criminality in Patients With Psychotic Disorders

et al. 2016

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Importance Absolute and relative risks of violence are increased in patients with psychotic disorders, but the contribution of triggers for violent acts to these risks is uncertain. Objective To examine whether a range of triggers for violent acts are associated with risks of violence in patients diagnosed with psychotic disorders and in individuals without a psychiatric diagnosis. Design, Setting, and Participants Using a sample of all individuals born in Sweden between 1958 and 1988 (N = 3 123 724), we identified patients in the National Patient Register who were diagnosed with schizophrenia spectrum disorders (n = 34 903) and bipolar disorder (n = 29 692), as well as unaffected controls (n = 2 763 012). We then identified, within each subsample, persons who had experienced any of the following triggers for violent acts between January 1, 2001, and December 15, 2013: exposure to violence, parental bereavement, self-harm, traumatic brain injury, unintentional injuries, and substance intoxication. By using within-individual models, we conducted conditional logistic regression to compare the risk of the individual engaging in violent acts in the week following the exposure to a trigger with the risk during earlier periods of equivalent length. All time-invariant confounders (eg, genetic and early environmental influences) were controlled for by this research design and we further adjusted for time-varying sociodemographic factors. Main outcomes and Measures Adjusted odds ratios (aORs) of violent crime occurring in the week following the exposure to a trigger event compared with earlier periods. Results Among the sample of 2 827 607 individuals (1 492 186 male and 1 335 421 female), all of the examined trigger events were associated with increased risk of violent crime in the week following exposure. The largest 1-week absolute risk of violent crime was observed following exposure to violence (70-177 violent crimes per 10 000 persons). For most triggers, the relative risks did not vary significantly by diagnosis, including unintentional injuries (aOR range, 3.5-4.8), self-harm (aOR range, 3.9-4.2), and substance intoxication (aOR range, 3.0-4.0). Differences by diagnosis included parental bereavement, which was significantly higher in patients with schizophrenia spectrum disorders (aOR, 5.0; 95% CI, 3.0-8.1) compared with controls (aOR, 1.7; 95% CI, 1.3-2.2). Conclusions and Relevance In addition to identifying risk factors for violence, clarifying the timing of the triggers may provide opportunities to improve risk assessment and management in individuals with psychotic disorders.

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“…Another related aim could be to encourage the overall benefits of a zero-alcohol lifestyle. Finally, this message needs to be part of a comprehensive overall campaign [11,12].Currently there are many small initiatives to reduce alcohol usage, but on their own they can generate comparatively slight effects. Hence a comprehensive multi-component programme is needed.…”

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confidence: 99%

Alcohol: Drink Less and Live More

Parrott¹

2016

ADSD

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The UK Chief Medical Officer recently revised its guidelines for alcohol drinking (2016, January 8 th ). They recommended drinking less than 14 units per week for men and women, and not to indulge in heavy drinking sessions. This report will be very useful for a current initiative by the National Union of Students (NUS), aimed at reducing the culture of heavy drinking on campuses across Britain [1]. The core problem is how to achieve this target, and in this regard we can learn from previous health campaigns. The simple message 'Don't drink and drive' was first introduced around fifty years ago in 1964, and it proved successful in changing attitudes and behaviours [2]. It was based on the emerging data which showed the increased risk of car accidents and deaths when under the influence of alcohol. Similarly the anti-cigarette smoking programmes from several decades ago led to enduring health gains. They followed the pioneering studies of smoking and non-smoking doctors in the UK by Doll and Hill [3], along with confirmatory studies from other countries [4,5]. The ensuing government-led public health campaigns helped to completely transform beliefs and attitudes. It should be noted that these changes in public consciousness were not sudden, but occurred more gradually over years and decades. They were facilitated by articles in popular magazines, lively debates between advocates and opponents on radio programmes, and other activities across the mass media. Over time, they led to reduced rates of initiation, and increased rates of smoking cessation. The health benefits to individuals, and cost savings for the health services, have been dramatic [4]. The core messages for the previous these health campaigns were simple statements or mantras: smoking causes cancer, drunk driving kills. We need a similar health message for alcohol drinking. Hence our following suggestion: 'Alcohol: Drink Less and Live More' . It is simple and general, and like many broad statements it has multiple meanings. In physical terms, it indicates health benefits and longer life expectancy [6]. It promises less liver disease, fewer cancers, and many other medical gains. Psychologically, it promises fewer personal accidents and self-injuries, less interpersonal violence and aggression. Other benefits would include fewer unwanted pregnancies, fewer rapes, a reduction in alcohol-related crimes and prison incarcerations. In terms of 'positive psychology' , it promises more enjoyment and greater happiness. In a recent pilot study from the University of Brighton and its Students' Union Partnership [7], not only was self-reported alcohol consumption markedly reduced, but those who took part in non-alcohol-focused events reported having a more enjoyable evening. Small amounts of alcohol can facilitate social interactions, and it is when larger amounts are taken that the problems occur [8][9][10]. Hence a core aim should be to encourage the 'continental' mode of drinking. Another related aim could be to encourage the overall benefits of a zero-alcohol...

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A comparison of the efficacy of brief interventions to reduce hazardous and harmful alcohol consumption between European and non‐European countries: a systematic review and meta‐analysis of randomized controlled trials

Cited by 47 publications

References 72 publications

Review article: Effectiveness of ultra‐brief interventions in the emergency department to reduce alcohol consumption: A systematic review

Review article: Effectiveness of ultra‐brief interventions in the emergency department to reduce alcohol consumption: A systematic review

Triggers for Violent Criminality in Patients With Psychotic Disorders

Alcohol: Drink Less and Live More

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