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Review of studies of interventions for heavy drinkers identified among general hospital inpatients concluded that multi-session brief interventions could reduce drinking. “Could” is an important qualifier: yet to be pinned down is why though sometimes they work, brief interventions often fail to produce significant effects.
STUDY 1997 HTM file
Performance contracting for substance abuse treatment
This US study finds that performance contracting may be associated with improvements in service utilisation and treatment outcomes, but does not appear to increase engagement with under-served populations.
HOT TOPIC 2016 HTM file
Prizes for not using drugs?
‘Hot topics’ offer background and analysis on important issues which sometimes generate heated debate. Contingency management programmes reward patients for complying with treatment or not engaging in undesired substance use. It works, but often only temporarily – and perhaps at the cost of eroding the patient’s confidence and motivation.
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.
From Brazilian primary care clinics a rare confirmation that a positive organisational climate featuring commitment to staff professional development and good links with the local community is associated with overcoming barriers to widely implementing screening and brief intervention programmes.
When a patient has screened positive for risky drinking, up pops a computerised prompt to remind the clinician to consider counselling. In one service for US ex-military personnel, this resulted in nearly three quarters of patients being counselled and a hint of consequentially reduced drinking; at another, findings were negative. Why the difference?
US trauma centres dealing with serious and often alcohol-related injuries ought to offer an environment conducive to brief alcohol interventions, but this first multi-site trial found motivational counselling more effective than minimal advice only when combined with a follow-up ‘booster’ phone call.
REVIEW 2015 HTM file
A comparison of the efficacy of brief interventions to reduce hazardous and harmful alcohol consumption between European and non-European countries: a systematic review and meta-analysis of randomized controlled trials
Amalgamation of results from relevant studies finds that in high-income nations brief alcohol advice to emergency or primary care patients remains effective whether trials take place in European or non-European drinking cultures and health service contexts. Impacts were however small and may not be duplicated in routine practice.
The primary care arm of the largest alcohol screening and brief intervention study yet conducted in Britain found that the proportion of risky drinkers fell just as much after the most minimal of screening and intervention methods as after more sophisticated and longer (but still brief) alternatives.
‘Do just the minimum’ seems the message of the emergency department arm of the largest alcohol screening and brief intervention study yet conducted in Britain; the proportion of risky drinkers fell no less after a brief warning than after more sophisticated and longer interventions.
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