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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 …