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Brief physician advice to problem drinkers reduced alcohol intake and societal costs

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 QUESTION: In patients with drinking problems, is brief advice given by a physician cost effective?

Design

Cost benefit analysis of a randomised controlled trial with 12 months of follow up.

Setting

17 community clinics in Wisconsin, United States, comprising practices of 64 family physicians and general internists.

Patients

774 patients who were 18–65 years of age (62% men) and drank >14 alcoholic drinks/week (>168 g alcohol/wk) (>11 drinks/wk for women [>132 g alcohol/wk]). Exclusion criteria were pregnancy, attendance at an alcohol treatment programme or symptoms of alcohol withdrawal in the previous year, physician advice to change alcohol use in the previous 3 months, consumption of >50 drinks/week (>600 g alcohol/wk), or symptoms of suicide.

Intervention

Patients were allocated to a brief physician advice intervention (n=392) or a control group (n=382). The intervention consisted of printed feedback on health behaviours and previous problem drinking, adverse effects of alcohol, drinking cues, and diary cards. Intervention group patients had two 15 minute physician visits 1 …

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