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Combining findings from randomised trials confirmed that brief advice to risky drinking primary care patients can reduce drinking; now the issue is whether in normal practice those benefits will be realised on a grand enough scale to create public health gains.
STUDY 2006 PDF file 264Kb
Ongoing support encourages GPs to advise heavy drinkers
Screening and brief intervention for risky drinking is a major plank in the English alcohol strategy. A WHO trial in six countries including England has shown that personal contact and ongoing support are needed to encourage even modest levels of intervention by GPs.
STUDY 2009 HTM file
Effectiveness of experimenter-provided and self-generated implementation intentions to reduce alcohol consumption in a sample of the general population: a randomized exploratory trial
When researchers surveyed people's drinking and then asked them to make concrete plans to drink sensibly, a month later the heavy drinkers among them had significantly cut their consumption. This British study could help extend the reach of brief intervention programmes.
With other similar work, this Canadian study suggests that internet-based programs which offer feedback to the user on their drinking in relation to the population and on the risks they may be running can lead to drinking reductions of the same order as face-to-face advice.
In the study of Swiss army conscripts, reflective listening emerged as possibly the key active ingredient in a brief alcohol intervention based on motivational interviewing.
UK-focused review for Britain's National Institute for Health and Clinical Excellence of what impedes or promotes the implementation of brief alcohol interventions at the level of the organisation, the staff doing the work, and the patients targeted by the programme.
At three London hospitals 4% of inpatients completed a brief alcohol intervention after being screened for hazardous drinking by ward staff. Staff were positive and on one ward nearly half the patients were screened and one in ten counselled, but the overall results are unlikely to dent the public health burden imposed by risky drinking.
This synthesis of nine relevant studies of non-student adult samples confirmed that computer-delivered self-help interventions offer a low-cost way to extend the public health impact of interventions for risky drinkers. Yet to be shown is that they can replace therapists for severely dependent individuals seeking treatment.
REVIEW 2012 HTM file
Computer based alcohol interventions
Worth trying but unproven for the UK and the general population and need evaluating, was the message of this review for the health service in Scotland of computer-based alcohol interventions as possible ways to extend the reach of treatment and of the national brief intervention programme.
Spending just ten minutes each on a drinking feedback and advice web site is leading over 2000 heavy drinking Dutch men a year to reduce to safer levels was the implication of this randomised trial from the Netherlands.
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