Authors' objectives:

To systematically review evidence for the efficacy of brief behavioral counseling interventions conducted in primary care settings to reduce risky/harmful alcohol consumption or patterns, and to link this evidence to results from other systematic reviews of alcohol screening in primary care populations.

Authors' results and conclusions: Good evidence supports the efficacy of brief, multi-contact primary care interventions for risky/harmful alcohol use in primary care patients identified through screening and screening-related assessment of at-risk drinking and alcohol use disorders. Patients in these trials underwent screening to identify those possibly in need of alcohol misuse intervention in primary care or elsewhere, followed by screening-related clinical assessment to qualify patients appropriate for primary care-based intervention or for referral to specialty treatment of abuse/dependence. Patients were screened generally using standardized self-report instruments alone (e.g., AUDIT), or in combination, (e.g., CAGE with standardized quantity and frequency questions) that have been found to be valid in primary care populations. After primary care brief, multi-contact interventions, patients reduced average drinks per week by 13%-34% and increased the proportion drinking at moderate or safe levels by 10%-19% compared with controls. Similar population-level reductions in average alcohol consumption have been projected to reduce the prevalence of alcohol abuse/dependence by 3%, while use of alcohol within safe/recommended levels has been epidemiologically related to reduced short-term (e.g., injuries, alcohol-related problems) and long-term (e.g., cirrhosis, total mortality) health risks.

Authors' recommendations: Brief, multi-contact behavioral counseling interventions among adult primary care patients are feasible and potentially highly effective components of an overall public health approach to reducing alcohol misuse. Future research should focus on developing implementation strategies that facilitate the adoption of these practices as a regular part of routine health care. Additional research is needed to develop effective interventions among sub-populations such as pregnant women, ethnic minorities, and adolescents.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.ahrq.gov/clinic/uspstf/uspsdrin.htm

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)