The Impact of Brief Alcohol Interventions in Primary Healthcare: A Systematic Review of Reviews

Abstract

Aims: The aim of the study was to assess the cumulative evidence on the effectiveness of brief alcohol interventions in primary healthcare in order to highlight key knowledge gaps for further research. Methods: An overview of systematic reviews and meta-analyses of the effectiveness of brief alcohol intervention in primary healthcare published between 2002 and 2012. Findings: Twenty-four systematic reviews met the eligibility criteria (covering a total of 56 randomized controlled trials reported across 80 papers). Across the included studies, it was consistently reported that brief intervention was effective for addressing hazardous and harmful drinking in primary healthcare, particularly in middle-aged, male drinkers. Evidence gaps included: brief intervention effectiveness in key groups (women, older and younger drinkers, minority ethnic groups, dependent/co-morbid drinkers and those living in transitional and developing countries); and the optimum brief intervention length and frequency to maintain longer-term effectiveness. Conclusion: This overview highlights the large volume of primarily positive evidence supporting brief alcohol intervention effects as well as some unanswered questions with regards to the effectiveness of brief alcohol intervention across different cultural settings and in specific population groups, and in respect of the optimum content of brief interventions that might benefit from further research.

Brief interventions for alcohol misuse

“…One recent comprehensive and rigorous systematic review of published systematic reviews provided an authoritative summary of this evidence. 22 Overall, across 24 systematic reviews (summarizing a total of 56 individual trials), brief alcohol interventions delivered in primary health care settings were effective in reducing harmful and hazardous drinking, despite a lack of positive findings in some individual trials. The authors noted that such null effects might be due to a Hawthorne effect, whereby simply joining a trial or having one's drinking recorded influenced the level of drinking.…”

Trajectories of Adolescent Alcohol Use in the Year Following a Brief Alcohol Intervention

“…Brief interventions, particularly among participants defined by the transtheoretical model of change as in the precontemplation stage (Prochaska et al, 1988), can be susceptible to decay of effects over time (O'Donnell et al, 2014). Adolescents referred to alcohol intervention studies for current problematic alcohol use will vary in their readiness to change.…”

Telling your patients to cut down on alcohol: does it work?

“…[13][14][15][16] Brief interventions can vary in their degree of complexity and duration, ranging from the provision of simple advice through to several sessions of motivational interviewing, and delivered by either the person who administered the screening test, a specialist nurse or via SMS, web or email. 17,18 There is some evidence to suggest that simply asking questions about consumption can change behaviour, 19 and that accepting an appointment with an alcohol health worker is as effective as actually attending one.…”