Comment: The quality of evidence is downgraded by study limitations (allocation concealment, sequence generation, incomplete outcome data).
Brief intervention is recommended for heavy alcohol users admitted to primary care or general hospital wards.assessed demographic, personality, and cognitive factors hypothesized to influence change after a brief motivational intervention. Students mandated for intervention following a campus alcohol violation (n=568) completed a baseline assessment, then received an intervention, and then completed a 1-month follow-up. Latent change score analyses revealed significant decrease in both alcohol use and problems 1 month after the intervention. In the final model that predicted change in alcohol use, four factors (male sex, a "fun seeking" disposition, more perceived costs and fewer perceived benefits of change) predicted smaller decreases in alcohol use over time. In the final model that predicted change in alcohol-related problems, three factors (stronger beliefs about the centrality of alcohol to college life, more perceived costs and fewer perceived benefits of change) predicted smaller decreases in problems over time."?>
A Cochrane review included 14 studies with a total of 4041 mainly male participants (16 years or older) admitted to general inpatient hospital care for any reason other than specifically for alcohol treatment. Patients receiving brief interventions (1 to 3 sessions) had a greater reduction in alcohol consumption compared to those in control groups at 6 month (MD in grams per week -69.43, 95% CI -128.14 to -10.72; 4 trials, n=453) and 9 months follow up (MD in grams per week -182.88, 95% CI -360.00 to -5.76; 1 trial, n=479) but this was not maintained at one year (MD in grams per week -33.62, 95% CI -82.27 to 15.03; 4 trials, n=1073). In addition there were significantly fewer deaths in the groups receiving brief interventions than in control groups at 6 months (RR 0.42, 95% CI 0.19 to 0.94; 4 trials, n=1166) and one year follow up (RR 0.60, 95% CI 0.40 to 0.91; 7 trials, n=2396). In one high-quality trial, heavy drinking episodes were decreased at 4, 9 and 12 months (MD -0.56, 95% CI -1.02 to -0.10; MD -0.78, 95% CI -1.32 to -0.24; MD -0.71, 95% CI -1.26 to -0.16 days per week respectively; n=616).
A Cochrane review included 69 studies with a total of 33 642 subjects. Most interventions were delivered in general practice or emergency care settings. Participants receiving brief intervention reduced their alcohol consumption compared to the control group (mean difference: -20 grams/week, 95% CI -28.36 to -11.81 g/week; 34 trials, n=15 197). Sub-group analysis confirmed the benefit of brief intervention both in men and in women. Extended intervention when compared with brief intervention had no greater reduction in alcohol consumption although findings were imprecise (MD 2 g/week, 95% CI -42 to 45; 3 studies, n=552).
Date of latest search: 2 April 2018