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How can infertility specialists integrate screening, brief intervention, and referral to treatment into their everyday practice?
In these UK national prevention guidelines, experts prioritised population-wide changes like price rises and outlet restrictions which affect everyone, independent of the choices they make. But in England government prefers to target what they see as the troublesome minority, not the responsible majority.
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?
An ambitious attempt to use research to understand the most effective and cost-effective set of policies for reducing alcohol-related harm in the English context, from taxation and price regulation to managing the drinking environment.
HOT TOPIC 2017 HTM file
‘My GP says I drink too much’: screening and brief intervention
One of our hot topics – important issues which sometimes generate heated debate. In the absence of more or less inescapable impediments to heavy drinking like ramping up the price of cheap alcohol, widespread screening and brief advice have been the great hope for drink-related public health improvements. Patchy effectiveness and poor implementation have led that ambition to be questioned.
Interventions delivered by nurses did lead to a reduction in excessive drinking in their patients, but there seemed to be no advantage of a structured brief intervention over standard advice.
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 2016 HTM file
Monitoring and evaluating Scotland’s alcohol strategy: Final annual report
The final report evaluating Scotland’s alcohol strategy concludes that while some evidence-based interventions have been implemented, failure to implement minimum unit pricing is likely to have limited the strategy’s contribution to declines in both alcohol consumption and related harm.
STUDY 2014 HTM file
The clinical effectiveness and cost-effectiveness of brief intervention for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial (SHEAR)
A major study conducted in London did not find clinically important reductions in drinking among excessive drinkers offered a brief intervention while attending sexual health clinics, nor did brief intervention seem a cost-effective use of health service resources.
Approaches to alcohol policy differ widely across the UK. Scottish policy appears to be most closely aligned with evidence-based recommendations, framing alcohol as a whole population issue, in contrast with UK government policy which is influenced to a greater extent by prevailing beliefs about personal responsibility for alcohol issues.
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