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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.
STUDY 2010 HTM file
Evaluation of an electronic clinical reminder to facilitate brief alcohol-counseling interventions in primary care
When a patient has screened positive for risky drinking, up pops a computerised prompt to remind the clinician to consider counselling, yet at a service for US ex-military personnel the reminder was rarely used and made no difference to patients' drinking. Why were results so different from those at other clinics?
STUDY 2019 HTM file
Cost-effectiveness of strategies to improve delivery of brief interventions for heavy drinking in primary care: results from the ODHIN trial
Could combinations of three strategies – training and support, financial reimbursement, and the opportunity to refer patients to a website – cost-effectively boost delivery of brief interventions in European primary care? The important aim was to find the best way to narrow the ‘implementation gap’ between the number of patients who could benefit from these interventions and those who receive them.
STUDY 2013 HTM file
Modelling the cost-effectiveness of alcohol screening and brief interventions in primary care in England
Simulation study calculated health care cost savings and benefits for patients in England which make routine GP-based screening and brief advice for excessive drinking look an unmissable bargain, but the key assumptions derived from studies divorced from how interventions would routinely be implemented.
STUDY 2016 HTM file
Strategies in primary healthcare to implement early identification of risky alcohol consumption: why do they work or not? A qualitative evaluation of the ODHIN study
What do primary care clinicians think would help them bridge the ‘implementation gap’ in screening for risky drinking and brief advice, and extend the potential benefits to a greater proportion of the population? A European trial found the answer differed depending on distinctive national circumstances.
STUDY 1992 HTM file
Health promotion in the general practice consultation: a minute makes a difference
‘A minute makes a difference in primary care consultations’, was the finding of a 1992 study about improving the capacity of general practitioners to screen for problems such as heavy drinking, smoking, and high blood pressure. But is extra time on the clock enough to secure routine (as opposed to more frequent) delivery of health promotion and brief intervention?
REVIEW 2018 HTM file
Effectiveness of brief alcohol interventions in primary care populations
Update of a key document forming the basis of claims that brief interventions work in ‘real-world’ settings. Combined findings from randomised trials confirm that brief advice in primary care can reduce drinking, but will those reductions be realised in contemporary routine practice?
STUDY 2008 HTM file
Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later
This huge US study set out to test whether widespread screening and brief intervention for illegal drug use (not just heavy drinking) could be implemented in a variety of general medical settings and whether it was effective. Both tests seem to have been passed, but with some important caveats.
STUDY 2010 HTM file
Cluster-randomized controlled trial of dissemination strategies of an online quality improvement programme for alcohol-related disorders
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.
REVIEW 2012 HTM file
Behavioral counseling after screening for alcohol misuse in primary care: a systematic review and meta-analysis for the U.S. Preventive Services Task Force
Amalgamated findings from studies of risky drinkers identified and counselled in primary care settings indicate that compared to screening and assessment only, brief counselling lead to greater reductions in drinking, gains reflected less strongly in some indicators of health. However, it is unclear whether the generally small impacts would be sustained in routine practice.
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