Identification and Intervention of Heavy Drinking in Middle‐Aged Men: Results and Follow‐up of 24–60 Months of Long‐Term Study with Randomized Controls

Abstract

In a continuing screening and intervention programme in Malmó, elevated serum-gamma-glutamyltransferase (GGT) values were used for selection of heavy drinkers. The study population consisted of 585 individuals born 1926-1933 with two consecutive GGT values in the upper decile of the GGT distribution, randomly allocated either to an intervention group of to a control group. The subjects in the intervention group were further investigated and 75% of them were judged to have elevated GGT values caused by alcohol consumption. These individuals were repeatedly encouraged to lower their overall alcohol consumption and GGT measurements were used as biofeedback method in the treatment program. The controls were informed by letter to be restrictive with their alcohol consumption and that they should receive new invitations for measurements of their liver enzymes after 2, 4, and 6 years. The intervention and control groups were well matched and followed over a 2-6-year period. Two and 4 years after the screening investigation, the GGT values in both groups were significantly decreased. There were differences, however, between the two groups with regard to sick absenteeism, hospitalization, and mortality. A significant reduction was found in sick absence during 4 years by 80%, in hospital days during 5 years by 60%, and in mortality during 6 years by 50% in the intervention group compared with the control group. Thus, the intervention program was effective in preventing medico-social consequences of heavy drinking.

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

“…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.…”

Evidence-based alcohol policy in the Americas: strengths, weaknesses, and future challenges

“…When treatment and early intervention are available to large segments of the population, there is some evidence that these services can reduce the rates of alcohol problems in a society (51,52). Nevertheless, specialized services (other than mutual help organizations) tend to be expensive and may not be cost-effective in developing countries unless they are integrated with the primary care system.…”

Effectiveness of strategies to implement brief alcohol intervention in primary healthcare

“…reduced alcohol intake to moderate levels [14]. Studies have shown that the positive effect of a BI session is sustained for at least two years [17,18] and that conducting BI is cost-effective [19]. This evidence suggests that BI carried out by PHC providers could be an influential tool with a substantial impact on public health.…”