A randomized clinical trial of brief interventions in primary health care: summary of a WHO project

Babor, Thomas F.; Grant, Marcus; Acuda, Wilson; Burns, Frances; Campillo, Carlos; Boca, Frances K. Del; Hodgson, Ray; Иванец, Н. Н.; Lukomskya, Marina; Machona, Marco; Rollnick, Steven; Resnick, Robert; Saunders, John B.; Skutle, Arvid; Connor, K. O’; Ernberg, G.; Kranzler, Henry R.; Lauerman, Richard; McRee, Bonnie

doi:10.1111/j.1360-0443.1994.tb00944.x

Cited by 129 publications

(131 citation statements)

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“…In particular, BI patients are the group that is most comparable with the studies in Bien et al's review. Our effect size of 0.72 for any drinking is larger than those of five studies that found statistical significance when BI was compared to a control group: Babor & Grant [22], Heather et al [23,27,29] and Daniels et al [26]. Finally, effect sizes for the studies for which pre-post changes in control-group outcomes were available, were consistently lower than SAMHSA's effect sizes.…”

Section: Comparisons With Results From Other Sbi Studiescontrasting

confidence: 71%

“…Standardized effect sizes from 14 of the studies reviewed by Bien et al [16] are given in Table 4 [ [22][23][24][25][26][27][28][29][30][31][32][33][34][35]. The within-group effects are described by the baseline to follow-up changes in alcohol use among patients receiving BI, and are thus similar in design to the standardized effect sizes from our analysis also given in Table 4.…”

Section: Comparisons With Results From Other Sbi Studiesmentioning

confidence: 77%

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Substance use outcomes of patients served by a large US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT)

2017

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Aims To estimate changes in the substance use behaviors of patients who received services as part of the US Substance Abuse and Mental Health Services Administration's (SAMHSA) Screening, Brief Intervention and Referral to Treatment (SBIRT) grant program. Methods We use a pre-post design and performance monitoring data collected by SBIRT organizations. For a sample of 17 575 patients, we compare pre-SBIRT substance use with substance use 6 months after receipt of SBIRT services. SBIRT's correlation with changes in substance use was estimated using generalized linear mixed models to account for the clustering of patients within health-care facility and US state. Results From pre-to post-SBIRT we found large and statistically significant decreases for almost every measure of substance use. Model-adjusted means indicate that the prevalence of alcohol use was lower 6 months later by 35.6%, heavy drinking by 43.4% and illicit drug use by 75.8%. Greater intervention intensity was associated with larger decreases in substance use. The study design does not support causal conclusions and estimated decreases in reported substance use are due, at least in part, to a well-known set of confounders and natural substance use patterns that may be unrelated to any particular SBIRT intervention.Conclusions Compared with previously published findings on the Screening, Brief Intervention and Referral to Treatment grant program, our estimates of substance use reduction were smaller, but still consistently large in absolute magnitude and within ranges of estimates from past trials of Screening, Brief Intervention and Referral to Treatment.

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Section: Comparisons With Results From Other Sbi Studiescontrasting

confidence: 71%

Section: Comparisons With Results From Other Sbi Studiesmentioning

confidence: 77%

Substance use outcomes of patients served by a large US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT)

2017

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“…Studies on this issue (10)(11)(12) showed that nurses are efficient in reducing excessive drinking in primary health care. These professionals have a potential to reduce the prevalence of drinking problems, however, the practices to face the problem are underused (11) and have little effect (10) . A study12 showing the opinions of nurses on drug users, demonstrated that they are predominantly viewed as sick and victims of social conditions.…”

Section: Introductionmentioning

confidence: 99%

Atendimento ao alcoolista em serviços de atenção primária à saúde: percepções e condutas do enfermeiro

2010

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Objective: To describe the perceptions and actions of registered nurses regarding the care of alcoholic persons in primary care services. Methods: This was a qualitative exploratory study with 10 registered nurses from three primary care services. Data were collected through tape-recordings and categorized through content analysis. Results: The care of alcoholic persons was characterized by fast care and focused on symptoms needing immediate nursing interventions. This type of care generated dissatisfaction of the alcoholic persons, because they should receive more attention in primary care services. Conclusions: Care of alcoholic persons and actions of registered nurses focused on the symptoms of acute intoxication only. There was no focus on early identification and prevention of problems related to the use of alcohol and alcoholism. Key Words: Primary Care Services; Alcohol, Alcoholism; Nursing Care. RESUMOObjetivo: Verificar como ocorre o atendimento ao paciente com problemas relacionados ao uso de álcool em serviços de atenção primária à saúde na percepção do enfermeiro, identificando suas condutas frente a esse usuário. Métodos: Estudo exploratório, qualitativo, envolvendo dez enfermeiros de três serviços da atenção primária à saúde. Os dados foram coletados por registro autogravado e submetidos à análise temática do conteúdo. Resultados: O atendimento ao alcoolista caracteriza-se por ser rápido e focado nos sintomas que norteiam as condutas do profissional. O tipo de assistência que vem prestando a essa população, gera insatisfação nos mesmos, pois acreditam que maior atenção deveria ser dada a esses indivíduos nos serviços. Conclusão: O atendimento ao alcoolista e as condutas do enfermeiro centralizam-se nos sintomas da intoxicação aguda, em detrimento de ações que visem à identificação precoce e prevenção do agravamento dos problemas relacionados ao álcool e ao alcoolismo. Descritores: Centros de saúde; Álcool; Alcoolismo; Cuidados de enfermagem. RESUMENObjetivo: Verificar como ocurre la atención al paciente con problemas relacionados al uso de alcohol en servicios de atención primaria a la salud bajo la percepción del enfermero, identificando sus conductas frente a ese usuario. Métodos: Estudio exploratorio y cualitativo, envolviendo diez enfermeros de tres servicios de atención primaria a la salud. Los datos fueron recolectados en un registro autograbado y sometidos a análisis temático de contenido. Resultados: La atención al alcohólico se caracteriza por ser rápida y enfocada en los síntomas que orientan las conductas del profesional. El tipo de asistencia que se está prestando a esa población, genera insatisfacción en la misma, ya que creen que una mejor atención debería ser dada a esos individuos en los servicios. Conclusión: La atención al alcohólico y las conductas del enfermero se centralizan en los síntomas de la intoxicación aguda, en detrimento de acciones que tendrían por objetivo identificar precozmente y prevenir el agravamiento de los problemas relacionados al alcohol y al alcohol...

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“…Completion of the AUDIT screening tool without any clinician feedback has itself been shown to be an effective brief intervention and is therefore more beneficial than merely providing women with information on the risks associated with alcohol use and breast cancer. 13 Completion of the AUDIT encourages women to reflect on their drinking level. The NSW Health clinical guidelines for nursing and midwifery practice in NSW support a selfhelp model of intervention when staff lack time to provide a more intensive intervention.…”

Section: Discussionmentioning

confidence: 99%

Another opportunity for prevention: assessing alcohol use by women attending breast screening services in Lismore, NSW

Daly¹,

Passey²,

Harvey³

2009

NSW Public Health Bull.

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As part of its routine program, BreastScreen New South Wales (NSW) assesses women for breast cancer risk factors. Alcohol use is not currently assessed in any BreastScreen NSW service, despite substantial evidence supporting the association between alcohol consumption and the risk of breast cancer. [1][2][3][4] Consumption of 30 g of alcohol each day (three standard drinks) is associated with a similar level of risk to other recognised risk factors for breast cancer, such as young age at menarche and family Another opportunity for prevention: assessing alcohol use by women attending breast screening services in Lismore, NSW Substantial epidemiological evidence supports the association between alcohol consumption and the risk of breast cancer; however, information on alcohol consumption is not routinely collected by breast screening services in NSW. This study was conducted to investigate the level of self-reported alcohol use among women accessing North Coast BreastScreen in Lismore, NSW. Two hundred and sixty-four consecutive women were screened using the Alcohol Use Disorders Identification Test. Their drinking status was categorised as low risk, risky or high risk. Two-thirds of the screened women (69.7%) were classified as low-risk drinkers; 9.8% as risky and 0.4% as high-risk drinkers. Although the risk of breast cancer increases with the amount of alcohol consumed, evidence suggests that even low-risk drinking is associated with increased risk of breast cancer. Implications for prevention activities by breast screening services are discussed. The current National Health and Medical Research Council (NHMRC) guidelines note that alcohol increases women's risk of breast cancer and the risk increases with the level of alcohol used. Compared with women who drink little or no alcohol, the risk of breast cancer is 35% higher in women who drink three to four standard drinks a day and 67% with more than four drinks a day. Even low level drinking is associated with some increase in risk. 4 The 2004 National Drug Strategy Household Survey found that just over half (58.1%) of women aged 60 years or more approved of regular (i.e. daily or nearly every day) alcohol use. Approval for regular drinking in younger age groups was higher, with 74.7% of 40-49-year-old women and 69% of 50-59-year-old women approving of regular drinking. The survey also showed that in the Australian adult female population, 9.6% used alcohol at a level considered to be risky or high risk for long-term harm from a range of chronic physical and psychological illnesses. 5 BreastScreen services are free to eligible women and the uptake is high, with 63.5% of women aged 45-54 years, 80.9% of women aged 55-64; and 84.2% of 65-74-year-old women reporting having received a screening mammogram in the previous 2 years. 6 For the North Coast region of NSW, the corresponding figures are 73.1%, 81.9% and 80.5% respectively. 6 We conducted a study to assess the level of self-reported alcohol use among women accessing North Coast BreastScreen. Michelle D. Daly...

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A randomized clinical trial of brief interventions in primary health care: summary of a WHO project

Cited by 129 publications

References 0 publications

Substance use outcomes of patients served by a large US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT)

Substance use outcomes of patients served by a large US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT)

Atendimento ao alcoolista em serviços de atenção primária à saúde: percepções e condutas do enfermeiro

Another opportunity for prevention: assessing alcohol use by women attending breast screening services in Lismore, NSW

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