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Therapeutics
A brief intervention reduced alcohol drinking for up to 48 months in problem drinkers

https://doi.org/10.1136/ebm.7.5.151

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    (2002) Alcohol Clin Exp Res 26, 36; Fleming MF, Mundt MP, French MT, et al.. Brief physician advice for problem drinkers: long-term efficacy and benefit-cost analysis.. Jan;. :. –43.
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 QUESTION: In people with problem drinking, is a brief intervention effective for reducing drinking in the long term?

    Design

    Randomised (unclear allocation concealment*), unblinded,* controlled trial with 48 months of follow up (Project TrEAT [Trial for Early Alcohol Treatment]).

    Setting

    64 primary care physician offices from 17 clinics in 10 southern Wisconsin counties, USA.

    Patients

    774 patients who were 18 to 65 years of age (62% men) and drank a large amount of alcohol weekly (> 14 drinks [168 g of alcohol] for men, > 11 drinks [132 g of alcohol] for women) or drank > 5 drinks on ≥ 4 occasions in the previous 30 days. Patients were excluded if they had formal alcohol treatment in the previous year or a history of alcohol withdrawal, were pregnant, or had suicide ideation. Follow up was 83% at 48 months.

    Intervention

    Patients were allocated to a brief intervention (n=392) or no intervention (n=382). All patients received a general health booklet containing prevention messages. Patients in the intervention group received two 15 minute sessions 1 month apart with their physician and two 5 minute follow up telephone calls from office nurses. The protocol was scripted and included a workbook with tasks for patients to complete at home.

    Main outcome measures

    Alcohol use, healthcare use, motor vehicle and legal events, mortality, and costs (1993 US dollars).

    Main results

    Analysis was by intention to treat. The intervention group had lower rates of 7 day alcohol use …

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