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No matter which dissemination strategy was tried, just 4 in 10 GPs in Germany logged in to a government funded online alcohol intervention education and support system. Even among the few practices who joined the study, training was poorly attended.
Seven years after the first alcohol harm reduction strategy for England, this audit finds treatment access and brief intervention work has progressed in London but funding is often precarious and GP services are surprisingly under-developed.
In Madrid, unusually a primary care brief alcohol intervention targeted heavy episodic or 'binge' drinking. The result was drinking reductions which probably saved lives due to less drunkenness and less drinking overall – and both screening and intervention were done by the doctors themselves, not specialist staff.
DOCUMENT 2010 HTM file
Alcohol in our lives: curbing the harm
Extensive policy report from New Zealand accepts evidence that alcohol-related harm is best reduced by population level measures, including raising prices, licensing reform with harm reduction as its prime objective, and restricting the availability of alcohol through reduced opening hours, age limits and curbs on promotion.
At over 50%, this US study's main achievement may have been to show that emergency department nurses can screen a high proportion of patients for risky drinking. After that point it suffered from a low intervention implementation rate, and no statistically significant benefits were found.
A few minutes with specially hired interventionists can curb the intake of heavy-drinking emergency patients, but in routine practice hospital staff will usually have to do this work. A US study tested this real-world scenario and found the modest drinking reductions were short-lived.
STUDY 2006 PDF file 198Kb
Drink-driving cut by 30-minute talk with hospital patients
Patients admitted to a US hospital following a traffic accident had fewer arrests for drink-driving after a short talk with hospital staff about their drinking, the first such finding and one which reinforced the case for hospital-based brief interventions.
This report on work in England and Wales describes a system creatively grappling with a huge drink problem among offenders, but one undermined by lack of evidence about what works and by under-resourcing linked to a dispute over whether health or probation should bear the core funding burden.
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.
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.
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