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Having mandated universal screening for alcohol problems, the US health system for ex military personnel here thoughtfully addresses how to measure the degree to which this led to appropriate implementation of brief interventions.
In this comprehensive analysis, screening for risky drinking and brief advice was estimated to be among the most cost-effective preventive services GPs could offer, ranking alongside common interventions such as screening for high blood pressure or immunisation against influenza.
Just a few minutes with specially hired screening and intervention staff can make a difference to emergency patients' drinking, but in the real world the hospital's own staff will usually do this work. A US study tested this real-world scenario and still found (modest) drinking reductions.
Negative findings from a Danish attempt to implement the primary care screening and brief intervention protocol for heavy drinkers which emerged from World Health Organization trials suggest it was right for the UK to turn away from universal screening.
STUDY 2005 PDF file 113Kb
Lasting benefits nine years after a brief alcohol intervention
A unique study from Norway discerned lasting benefits from a brief alcohol intervention nine years after risky drinkers had been identified during mass screening for heart disease and other medical risk factors.
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.
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.
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.
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