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An ultra-brief alcohol intervention in the emergency department may have limited effectiveness in the short term, but with the large number of people attending hospitals at risk of alcohol-related harm, it could still have a measurable population effect if delivered routinely.
HOT TOPIC 2018 HTM file
Computerised therapies: sacrificing effectiveness for wider access?
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Among culturally accepted vehicles for delivering substance use interventions, computers, mobile phones and tablets are joining face-to-face work. Are we sacrificing effectiveness for convenience and economy?
Modern preventive interventions to reduce young people’s drinking rely heavily on correcting misperceptions that their peers drink more, but among 2611 students recruited from 122 UK universities, no reliable impacts were found, results in line with disappointing results from other studies.
A US study of young people in rural primary care settings finds that alcohol use disorders can be identified with a single question about frequency of drinking.
In the Netherlands an intensive cognitive-behavioural treatment programme for problem drinkers based on messages sent via a web site between therapist and patient achieved substantial remission in drinking and improvements in health – promising results undermined somewhat by how few patients were followed up.
REVIEW 2015 HTM file
Prevention of addictive behaviours
Based largely on existing reviews, this report for the German Federal Centre for Health Education comprehensively assesses substance use prevention approaches. Among its many conclusions are that approaches based solely on information provision are ineffective, in contrast to the more positive evidence for lifeskills and multi-component community programmes.
A computer-delivered brief intervention plus booster mailings increased the alcohol abstinence rate and improved pregnancy outcomes among risky drinking pregnant women recruited at a US antenatal clinic, though in this small pilot trial the results were not statistically significant.
Computerisation promises to spread the consumption-moderating benefits of alcohol screening and brief advice or treatment across the population, overcoming resource and access limitations to in-person interventions, but small and transient effects may not be enough to mitigate the health and social consequences of drinking.
US students starting courses at community colleges drank less after being randomly allocated to an online alcohol risk-reduction programme but there were no effects on adverse consequences of drinking or on use of strategies to prevent these.
A rare ‘real world’ trial of whether a routine and feasible brief alcohol intervention can have population-wide public health benefits found that among university students in Sweden, web-based screening had very minor impacts which were not enhanced by feeding back the results.
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