Brief Physician Advice for Problem Alcohol Drinkers: A Randomized Controlled Trial in Community-Based Primary Care Practices

Fleming, Michael F.

doi:10.1001/jama.1997.03540370029032

Cited by 538Substance Abuse Treatment and OutcomesAlcohol Consumption and Health EffectsOpioid Use Disorder Treatment

Brief Physician Advice for Problem Alcohol Drinkers: A Randomized Controlled Trial in Community-Based Primary Care Practices

Fleming, Michael F.·1997·JAMA

DOI 10.1001/jama.1997.03540370029032

Open this paper in CoChat — free account

Abstract

Objective. —Project TrEAT (Trial for Early Alcohol Treatment) was designed to test the efficacy of brief physician advice in reducing alcohol use and health care utilization in problem drinkers. Design. —Randomized controlled clinical trial with 12-month follow-up. Setting. —A total of 17 community-based primary care practices (64 physicians) located in 10 Wisconsin counties. Participants. —Of the 17 695 patients screened for problem drinking, 482 men and 292 women met inclusion criteria and were randomized into a control (n=382) or an experimental (n=392) group. A total of 723 subjects (93%) participated in the 12-month follow-up procedures. Intervention. —The intervention consisted of two 10- to 15-minute counseling visits delivered by physicians using a scripted workbook that included advice, education, and contracting information. Main Outcome Measures. —Alcohol use measures, emergency department visits, and hospital days. Results. —There were no significant differences between groups at baseline on alcohol use, age, socioeconomic status, smoking status, rates of depression or anxiety, frequency of conduct disorders, lifetime drug use, or health care utilization. At the time of the 12-month follow-up, there were significant reductions in 7-day alcohol use (mean number of drinks in previous 7 days decreased from 19.1 at baseline to 11.5 at 12 months for the experimental group vs 18.9 at baseline to 15.5 at 12 months for controls;t=4.33;P<.001), episodes of binge drinking (mean number of binge drinking episodes during previous 30 days decreased from 5.7 at baseline to 3.1 at 12 months for the experimental group vs 5.3 at baseline to 4.2 at 12 months for controls;t=2.81;P<.001), and frequency of excessive drinking (percentage drinking excessively in previous 7 days decreased from 47.5% at baseline to 17.8% at 12 months for the experimental group vs 48.1% at baseline to 32.5% at 12 months for controls;t=4.53;P<.001). The ϰ2test of independence revealed a significant relationship between group status and length of hospitalization over the study period for men (P<.01). Conclusions. —This study provides the first direct evidence that physician intervention with problem drinkers decreases alcohol use and health resource utilization in the US health care system.

Integrity signals

Registry

Crossref · 10.1001/jama.1997.03540370029032

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Power calculations used a published effect size of 0.33; a sample of 900 gave more than 0.80 power to detect low-to-moderate effects with a 0.05 type I error rate.
“Power calculations were based on published data38 indicating an expected effect of 0.33 in reduction of alcohol use between the experimental and control conditions. A total sample of 900 patients provided power (>0.80) to detect the hypothesized low-to moderate-sized effects (assuming a type I error of 0.05).”
From A Brief Intervention Reduces Hazardous and Harmful Drinking in Emergency Department Patients (2012) · cites this paper as [38]
A total of 52 studies met our inclusion criteria.
“A total of 52 studies met our inclusion criteria, with three studies presenting different outcomes for the same data and therefore considered as one.35–37”
From How effective are brief interventions in reducing alcohol consumption: do the setting, practitioner group and content matter? Findings from a systematic review and metaregression analysis (2016) · cites this paper as [35]

Verbal report methods in clinical research on alcoholism: response bias and its minimization.
Babor, T. F., Stephens, R. S., & Marlatt, G. A. (1987) · Journal of Studies on Alcohol · doi:10.15288/jsa.1987.48.410 · Cited by 488 · see citing works

Flagged first, then by citations

Sorted by citations

The AUDIT Alcohol Consumption Questions (AUDIT-C)<subtitle>An Effective Brief Screening Test for Problem Drinking</subtitle>
Bush, K. (1998) · Archives of Internal Medicine · doi:10.1001/archinte.158.16.1789 · Cited by 6,196 · see citing works
Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Alcohol Abuse and Dependence in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions
Hasin, D. S., Stinson, F. S., Ogburn, E., & Grant, B. F. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.7.830 · Cited by 2,908 · see citing works
Effectiveness of brief alcohol interventions in primary care populations
Kaner, E. F., Beyer, F. R., Muirhead, C., Campbell, F., Pienaar, E. D., Bertholet, N., Daeppen, J. B., Saunders, J. B., & Burnand, B. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004148.pub4 · Cited by 1,665 · see citing works
Brief interventions for alcohol problems: a meta‐analytic review of controlled investigations in treatment‐seeking and non‐treatment‐seeking populations
Moyer, A., Finney, J. W., Swearingen, C. E., & Vergun, P. (2002) · Addiction · doi:10.1046/j.1360-0443.2002.00018.x · Cited by 1,092 · see citing works
Evaluating primary care behavioral counseling interventions An evidence-based approach
Whitlock, E. (2002) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(02)00415-4 · Cited by 1,057 · see citing works
Binge Drinking Among US Adults
Naimi, T. S., Brewer, R. D., Mokdad, A., Denny, C., Serdula, M. K., & Marks, J. S. (2003) · JAMA · doi:10.1001/jama.289.1.70 · Cited by 987 · see citing works
Relapse Prevention for Alcohol and Drug Problems: That Was Zen, This Is Tao
Witkiewitz, K., & Marlatt, G. A. (2004) · American Psychologist · doi:10.1037/0003-066x.59.4.224 · Cited by 880 · see citing works
Effectiveness of brief alcohol interventions in primary care populations
Kaner, E. F. S., Dickinson, H. O., Beyer, F. R., Campbell, F., Schlesinger, C., Heather, N., Saunders, J. B., Burnand, B., & Pienaar, E. D. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004148.pub3 · Cited by 746 · see citing works
Comparison of extended versus brief treatments for marijuana use.
Stephens, R. S., Roffman, R. A., & Curtin, L. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.5.898 · Cited by 711 · see citing works
Reduction of Alcohol Consumption by Brief Alcohol Intervention in Primary Care: Systematic Review and Meta-analysis
Bertholet, N. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.9.986 · Cited by 710 · see citing works
Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: Comparison at intake and 6 months later
Madras, B. K., Compton, W. M., Avula, D., Stegbauer, T., Stein, J. B., & Clark, H. W. (2009) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2008.08.003 · Cited by 663 · see citing works
Substance Abuse Among Older Adults
Kuerbis, A., Sacco, P., Blazer, D. G., & Moore, A. A. (2014) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2014.04.008 · Cited by 505 · see citing works
Harm reduction approaches to alcohol use
Marlatt, G. A., & Witkiewitz, K. (2002) · Addictive Behaviors · doi:10.1016/s0306-4603(02)00294-0 · Cited by 491 · see citing works
Mental health care for older adults: recent advances and new directions in clinical practice and research
Reynolds, C. F., Jeste, D. V., Sachdev, P. S., & Blazer, D. G. (2022) · World Psychiatry · doi:10.1002/wps.20996 · Cited by 465 · see citing works
The effectiveness of brief alcohol interventions in primary care settings: A systematic review
KANER, E. F. S., DICKINSON, H. O., BEYER, F., PIENAAR, E., SCHLESINGER, C., CAMPBELL, F., SAUNDERS, J. B., BURNAND, B., & HEATHER, N. (2009) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2009.00071.x · Cited by 434 · see citing works
Behavioral counseling after screening for alcohol misuse in primary care: A systematic review and meta-analysis for the U.S. Preventive Services Task Force
Jonas, D. E., Garbutt, J. C., Amick, H. R., Brown, J. M., Brownley, K. A., Council, C. L., Viera, A. J., Wilkins, T. M., Schwartz, C. J., Richmond, E. M., et al. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-157-9-201211060-00544 · Cited by 387 · see citing works
Benefit-Cost Analysis of Brief Physician Advice With Problem Drinkers in Primary Care Settings
Fleming, M. F., Mundt, M. P., French, M. T., Manwell, L. B., Stauffacher, E. A., & Barry, K. L. (2000) · Medical Care · doi:10.1097/00005650-200001000-00003 · Cited by 355 · see citing works
Self-citation
Effectiveness of the AUDIT-C as a Screening Test for Alcohol Misuse in Three Race/Ethnic Groups
Frank, D., DeBenedetti, A. F., Volk, R. J., Williams, E. C., Kivlahan, D. R., & Bradley, K. A. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0594-0 · Cited by 336 · see citing works
Alcohol Interventions for Trauma Patients Treated in Emergency Departments and Hospitals: A Cost Benefit Analysis
Gentilello, L. M., Ebel, B. E., Wickizer, T. M., Salkever, D. S., & Rivara, F. P. (2005) · Annals of Surgery · doi:10.1097/01.sla.0000157133.80396.1c · Cited by 293 · see citing works
Integrating screening, brief intervention, and referral to treatment (SBIRT) into clinical practice settings: a brief review
Agerwala, S. M., & McCance-Katz, E. F. (2012) · Journal of Psychoactive Drugs · doi:10.1080/02791072.2012.720169 · Cited by 258 · see citing works
Efficacy of Brief Interventions for Hazardous Drinkers in Primary Care: Systematic Review and Meta‐Analyses
Ballesteros, J., Duffy, J. C., Querejeta, I., Ariño, J., & González‐Pinto, A. (2004) · Alcoholism: Clinical and Experimental Research · doi:10.1097/01.alc.0000122106.84718.67 · Cited by 251 · see citing works
Screening and Behavioral Counseling Interventions to Reduce Unhealthy Alcohol Use in Adolescents and Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force
O’Connor, E. A., Perdue, L. A., Senger, C. A., Rushkin, M., Patnode, C. D., Bean, S. I., & Jonas, D. E. (2018) · JAMA · doi:10.1001/jama.2018.12086 · Cited by 249 · see citing works
Alcohol screening and brief intervention in primary care: Absence of evidence for efficacy in people with dependence or very heavy drinking
SAITZ, R. (2010) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2010.00217.x · Cited by 241 · see citing works
Screening and intervention for alcohol problems: A national survey of primary care physicians and psychiatrists
Friedmann, P. D., McCullough, D., Chin, M. H., & Saitz, R. (2000) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2000.03379.x · Cited by 232 · see citing works
Brief motivational interviewing for teens at risk of substance use consequences: A randomized pilot study in a primary care clinic
D'Amico, E. J., Miles, J. N. V., Stern, S. A., & Meredith, L. S. (2008) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2007.08.008 · Cited by 231 · see citing works
Effectiveness of Brief Interventions to Reduce Alcohol Intake in Primary Health Care Populations: A Meta-analysis
Poikolainen, K. (1999) · Preventive Medicine · doi:10.1006/pmed.1999.0467 · Cited by 211 · see citing works
A Brief Intervention Reduces Hazardous and Harmful Drinking in Emergency Department Patients
D'Onofrio, G., Fiellin, D. A., Pantalon, M. V., Chawarski, M. C., Owens, P. H., Degutis, L. C., Busch, S. H., Bernstein, S. L., & O'Connor, P. G. (2012) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2012.02.006 · Cited by 207 · see citing works
INTERVENTION FOR EXCESSIVE ALCOHOL CONSUMPTION IN PRIMARY HEALTH CARE: ATTITUDES AND PRACTICES OF ENGLISH GENERAL PRACTITIONERS
Kaner, E. F. S. (1999) · Alcohol and Alcoholism · doi:10.1093/alcalc/34.4.559 · Cited by 204 · see citing works
Brief Intervention for Problem Drug Use in Safety-Net Primary Care Settings: A Randomized Clinical Trial
Roy-Byrne, P., Bumgardner, K., Krupski, A., Dunn, C., Ries, R., Donovan, D., West, I. I., Maynard, C., Atkins, D. C., Graves, M. C., et al. (2014) · JAMA · doi:10.1001/jama.2014.7860 · Cited by 188 · see citing works
Factors influencing inquiry about patients’ alcohol consumption by primary health care physicians: qualitative semi-structured interview study
Aira, M., Kauhanen, J., Larivaara, P., & Rautio, P. (2003) · Family Practice · doi:10.1093/fampra/cmg307 · Cited by 164 · see citing works
Psychiatric Issues in Multiple Sclerosis
Chwastiak, L. A., & Ehde, D. M. (2007) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2007.07.003 · Cited by 166 · see citing works
Computer-facilitated substance use screening and brief advice for teens in primary care: An international trial
Harris, S. K., Csémy, L., Sherritt, L., Starostova, O., Van Hook, S., Johnson, J., Boulter, S., Brooks, T., Carey, P., Kossack, R., et al. (2012) · Pediatrics · doi:10.1542/peds.2011-1624 · Cited by 163 · see citing works
A qualitative study of nurses' attitudes and practices regarding brief alcohol intervention in primary health care
Lock, C. A., Kaner, E., Lamont, S., & Bond, S. (2002) · Journal of Advanced Nursing · doi:10.1046/j.1365-2648.2002.02294.x · Cited by 162 · see citing works
Treatment of Problem Alcohol Use in Women of Childbearing Age: Results of a Brief Intervention Trial
Manwell, L. B., Fleming, M. F., Mundt, M. P., Stauffacher, E. A., & Barry, K. L. (2000) · Alcoholism: Clinical and Experimental Research · doi:10.1111/j.1530-0277.2000.tb04570.x · Cited by 138 · see citing works
Self-citation
How effective are brief interventions in reducing alcohol consumption: do the setting, practitioner group and content matter? Findings from a systematic review and metaregression analysis
Platt, L., Melendez-Torres, G. J., O'Donnell, A., Bradley, J., Newbury-Birch, D., Kaner, E., & Ashton, C. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-011473 · Cited by 136 · see citing works
Reduction in heavy drinking as a treatment outcome in alcohol dependence
Gastfriend, D. R., Garbutt, J. C., Pettinati, H. M., & Forman, R. F. (2007) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2006.09.008 · Cited by 139 · see citing works
Brief Intervention for Medical Inpatients with Unhealthy Alcohol Use: <b>A Randomized, Controlled Trial</b>
Saitz, R., Palfai, T. P., Cheng, D. M., Horton, N. J., Freedner, N., Dukes, K., Kraemer, K. L., Roberts, M. S., Guerriero, R. T., & Samet, J. H. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-3-200702060-00005 · Cited by 137 · see citing works
Effectiveness of individual lifestyle interventions in reducing cardiovascular disease and risk factors
Ketola, E., Sipilä, R., & Mäkelä, M. (2000) · Annals of Medicine · doi:10.3109/07853890009011767 · Cited by 135 · see citing works
The long‐term effectiveness of brief interventions for unsafe alcohol consumption: a 10‐year follow‐up
Wutzke, S. E., Conigrave, K. M., Saunders, J. B., & Hall, W. D. (2002) · Addiction · doi:10.1046/j.1360-0443.2002.00080.x · Cited by 135 · see citing works
Brief intervention for hazardous and harmful drinkers in the emergency department
D'Onofrio, G., Pantalon, M. V., Degutis, L. C., Fiellin, D. A., Busch, S. H., Chawarski, M. C., Owens, P. H., & O'Connor, P. G. (2008) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2007.11.028 · Cited by 129 · see citing works
Alcohol screening and brief intervention in a college student health center: a randomized controlled trial
Schaus, J. F., Sole, M. L., McCoy, T. P., Mullett, N., & O'Brien, M. C. (2009) · Journal of Studies on Alcohol and Drugs, Supplement · doi:10.15288/jsads.2009.s16.131 · Cited by 121 · see citing works
Treatment of marijuana dependence: a review of the literature.
McRae, A. L., Budney, A. J., & Brady, K. T. (2003) · Journal of Substance Abuse Treatment · doi:10.1016/s0740-5472(03)00041-2 · Cited by 115 · see citing works
Effects of two types of brief intervention and readiness to change on alcohol use in hazardous drinkers
Maisto, S. A., Conigliaro, J., McNeil, M., Kraemer, K., Conigliaro, R. L., & Kelley, M. E. (2001) · Journal of Studies on Alcohol · doi:10.15288/jsa.2001.62.605 · Cited by 115 · see citing works
Alcohol and illicit drug abuse and the risk of violent death in the home
Rivara, F. P. (1997) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.1997.03550070061039 · Cited by 116 · see citing works
The efficacy of two brief intervention strategies among injured, at-risk drinkers in the emergency department: impact of tailored messaging and brief advice
Blow, F. C., Barry, K. L., Walton, M. A., Maio, R. F., Chermack, S. T., Bingham, C. R., Ignacio, R. V., & Strecher, V. J. (2006) · Journal of Studies on Alcohol · doi:10.15288/jsa.2006.67.568 · Cited by 115 · see citing works
The relative contribution of outcome domains in the total economic benefit of addiction interventions: A review of first findings
McCollister, K. E., & French, M. T. (2003) · Addiction · doi:10.1111/j.1360-0443.2003.00541.x · Cited by 114 · see citing works
Evaluation of a brief intervention in an inner-city emergency department
Bazargan-Hejazi, S., Bing, E., Bazargan, M., Der-Martirosian, C., Hardin, E., Bernstein, J., & Bernstein, E. (2005) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2004.10.014 · Cited by 112 · see citing works
Evaluation of a telephone-based stepped care intervention for alcohol-related disorders: a randomized controlled trial
Bischof, G., Grothues, J. M., Reinhardt, S., Meyer, C., John, U., & Rumpf, H.-J. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2007.10.003 · Cited by 108 · see citing works
Change over time in alcohol consumption in control groups in brief intervention studies: systematic review and meta-regression study
Jenkins, R. J., McAlaney, J., & McCambridge, J. (2009) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2008.09.016 · Cited by 103 · see citing works
Physician advice about smoking and drinking
Denny, C. H., Serdula, M. K., Holtzman, D., & Nelson, D. E. (2003) · American Journal of Preventive Medicine · doi:10.1016/s0749-3797(02)00568-8 · Cited by 102 · see citing works
Promoting Self‐Change With Alcohol Abusers: A Community‐Level Mail Intervention Based on Natural Recovery Studies
Sobell, L. C., Sobell, M. B., Leo, G. I., Agrawal, S., Johnson‐Young, L., & Cunningham, J. A. (2002) · Alcoholism: Clinical and Experimental Research · doi:10.1111/j.1530-0277.2002.tb02624.x · Cited by 105 · see citing works
Providing web-based feedback and social norms information to reduce student alcohol intake: a multisite investigation
Bewick, B. M., West, R., Gill, J., O'May, F., Mulhern, B., Barkham, M., & Hill, A. J. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1461 · Cited by 99 · see citing works
Promotoras as Mental Health Practitioners in Primary Care: A Multi-Method Study of an Intervention to Address Contextual Sources of Depression
Waitzkin, H., Getrich, C., Heying, S., Rodríguez, L., Parmar, A., Willging, C., Yager, J., & Santos, R. (2011) · Journal of Community Health · doi:10.1007/s10900-010-9313-y · Cited by 98 · see citing works
Screening and Brief Intervention for Unhealthy Drug Use in Primary Care Settings: Randomized Clinical Trials Are Needed
Saitz, R., Alford, D. P., Bernstein, J., Cheng, D. M., Samet, J., & Palfai, T. (2010) · Journal of Addiction Medicine · doi:10.1097/adm.0b013e3181db6b67 · Cited by 95 · see citing works
ATTITUDES OF SWEDISH GENERAL PRACTITIONERS AND NURSES TO WORKING WITH LIFESTYLE CHANGE, WITH SPECIAL REFERENCE TO ALCOHOL CONSUMPTION
GEIRSSON, M., BENDTSEN, P., & SPAK, F. (2005) · Alcohol and Alcoholism · doi:10.1093/alcalc/agh185 · Cited by 93 · see citing works
Effectiveness of brief interventions after alcohol-related vehicular injury: a randomized controlled trial
Sommers, M. S., Dyehouse, J. M., Howe, S. R., Fleming, M., Fargo, J. D., & Schafer, J. C. (2006) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/01.ta.0000221756.67126.91 · Cited by 90 · see citing works
Self-citation
Cost-effectiveness analysis of a brief intervention delivered to problem drinkers presenting at an inner-city hospital emergency department
Kunz, F. M., French, M. T., & Bazargan-Hejazi, S. (2004) · Journal of Studies on Alcohol · doi:10.15288/jsa.2004.65.363 · Cited by 89 · see citing works
EARLY INTERVENTION FOR PROBLEM DRINKERS: READINESS TO PARTICIPATE AMONG GENERAL PRACTITIONERS AND NURSES IN SWEDISH PRIMARY HEALTH CARE
Johansson, K. (2002) · Alcohol and Alcoholism · doi:10.1093/alcalc/37.1.38 · Cited by 84 · see citing works
Brief Intervention Decreases Drinking Frequency in HIV-Infected, Heavy Drinking Women: Results of a Randomized Controlled Trial
Chander, G., Hutton, H. E., Lau, B., Xu, X., & McCaul, M. E. (2015) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000000679 · Cited by 83 · see citing works
Brief physician advice for heavy drinking college students: a randomized controlled trial in college health clinics
Fleming, M. F., Balousek, S. L., Grossberg, P. M., Mundt, M. P., Brown, D., Wiegel, J. R., Zakletskaia, L. I., & Saewyc, E. M. (2010) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2010.71.23 · Cited by 83 · see citing works
Self-citation
Effectiveness of nurse-led brief alcohol intervention: a cluster randomized controlled trial
Lock, C. A., Kaner, E., Heather, N., Doughty, J., Crawshaw, A., McNamee, P., Purdy, S., & Pearson, P. (2006) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2006.03836.x · Cited by 81 · see citing works
Estudo da efetividade da intervenção breve para o uso de álcool e outras drogas em adolescentes atendidos num serviço de assistência primária à saúde
De Micheli, D., Fisberg, M., & Formigoni, M. L. O. S. (2004) · Revista da Associação Médica Brasileira · doi:10.1590/s0104-42302004000300040 · Cited by 74 · see citing works
A randomized trial of a brief primary-care-based intervention for reducing at-risk drinking practices
Curry, S. J., Ludman, E. J., Grothaus, L. C., Donovan, D., & Kim, E. (2003) · Health Psychology · doi:10.1037/0278-6133.22.2.156 · Cited by 74 · see citing works
Brief intervention for female heavy drinkers in routine general practice: a 3-year randomized, controlled study
Aalto, M., Saksanen, R., Laine, P., Forsström, R., Raikaa, M., Kiviluoto, M., Seppä, K., & Sillanaukee, P. (2000) · Alcoholism: Clinical and Experimental Research · doi:10.1111/j.1530-0277.2000.tb01969.x · Cited by 70 · see citing works
Brief Physician Advice For High-Risk Drinking Among Young Adults
Grossberg, P. M. (2004) · The Annals of Family Medicine · doi:10.1370/afm.122 · Cited by 69 · see citing works
Mechanisms of change in control group drinking in clinical trials of brief alcohol intervention: Implications for bias toward the null
BERNSTEIN, J. A., BERNSTEIN, E., & HEEREN, T. C. (2010) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2010.00174.x · Cited by 68 · see citing works
Recent suicidal ideation among patients in an inner city emergency department
Ilgen, M. A., Walton, M. A., Cunningham, R. M., Barry, K. L., Chermack, S. T., De Chavez, P., & Blow, F. C. (2009) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2009.39.5.508 · Cited by 62 · see citing works
Low identification of alcohol use disorders in general practice in England
Cheeta, S., Drummond, C., Oyefeso, A., Phillips, T., Deluca, P., Perryman, K., & Coulton, S. (2008) · Addiction · doi:10.1111/j.1360-0443.2008.02198.x · Cited by 62 · see citing works
Use of Alcohol Screening and Brief Interventions in Primary Care Settings: Implementation and Barriers
Barry, K. L., Blow, F. C., Willenbring, M., McCormick, R., Brockmann, L. M., & Visnic, S. (2004) · Substance Abuse · doi:10.1300/j465v25n01_05 · Cited by 63 · see citing works
A comparison of the efficacy of brief interventions to reduce hazardous and harmful alcohol consumption between European and non‐European countries: a systematic review and meta‐analysis of randomized controlled trials
Elzerbi, C., Donoghue, K., & Drummond, C. (2015) · Addiction · doi:10.1111/add.12960 · Cited by 64 · see citing works
Emergency department-based brief intervention to reduce risky driving and hazardous/harmful drinking in young adults: a randomized controlled trial
Sommers, M. S., Lyons, M. S., Fargo, J. D., Sommers, B. D., McDonald, C. C., Shope, J. T., & Fleming, M. F. (2013) · Alcoholism: Clinical and Experimental Research · doi:10.1111/acer.12142 · Cited by 59 · see citing works
Self-citation
A comparison of brief intervention versus simple advice for alcohol use disorders in a North India community-based sample followed for 3 months
Pal, H. R., Yadav, D., Mehta, S., & Mohan, I. (2007) · Alcohol and Alcoholism · doi:10.1093/alcalc/agm009 · Cited by 60 · see citing works
Regression to the mean and alcohol consumption: A cohort study exploring implications for the interpretation of change in control groups in brief intervention trials
McCambridge, J., Kypri, K., & McElduff, P. (2014) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.11.017 · Cited by 54 · see citing works
Effects of Brief Substance Use Interventions Delivered in General Medical Settings: A Systematic Review and Meta-Analysis
Tanner‐Smith, E. E., Parr, N. J., Schweer‐Collins, M., & Saitz, R. (2022) · Addiction · doi:10.1111/add.15674 · Cited by 54 · see citing works
The effectiveness of brief intervention among injured patients with alcohol dependence: who benefits from brief interventions?
Field, C. A., & Caetano, R. (2010) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2009.11.025 · Cited by 53 · see citing works
The efficacy-effectiveness distinction in trials of alcohol brief intervention
Heather, N. (2014) · Addiction Science & Clinical Practice · doi:10.1186/1940-0640-9-13 · Cited by 48 · see citing works
AESOPS: a randomised controlled trial of the clinical effectiveness and cost-effectiveness of opportunistic screening and stepped care interventions for older hazardous alcohol users in primary care
Watson, J., Crosby, H., Dale, V., Tober, G., Wu, Q., Lang, J., McGovern, R., Newbury-Birch, D., Parrott, S., Bland, J., et al. (2013) · Health Technol Assess · doi:10.3310/hta17250 · Cited by 47 · see citing works
General practitioners' diagnostic skills and referral practices in managing patients with drug and alcohol‐related health problems: implications for medical training and education programmes
FUCITO, U. M., GOMES, B. S., MURNION, B., & HABER, P. S. (2003) · Drug and Alcohol Review · doi:10.1080/09595230310001613930 · Cited by 45 · see citing works
Motivational interviewing with hazardous drinkers
Beckham, N. (2007) · Journal of the American Academy of Nurse Practitioners · doi:10.1111/j.1745-7599.2006.00200.x · Cited by 44 · see citing works
Screening and brief intervention targeting risky drinkers in Danish general practice - a pragmatic controlled trial
Beich, A., Gannik, D., Saelan, H., & Thorsen, T. (2007) · Alcohol and Alcoholism · doi:10.1093/alcalc/agm063 · Cited by 41 · see citing works
Detection and management of alcohol use disorders in German primary care influenced by non-clinical factors
Berner, M. M., Harter, M., Kriston, L., Lohmann, M., Ruf, D., Lorenz, G., & Mundle, G. (2007) · Alcohol and Alcoholism · doi:10.1093/alcalc/agm013 · Cited by 35 · see citing works
The efficacy of a brief intervention to reduce alcohol use in persons with HIV in South Africa, a randomized clinical trial
Huis in ‘t Veld, D., Ensoy-Musoro, C., Pengpid, S., Peltzer, K., & Colebunders, R. (2019) · PLOS ONE · doi:10.1371/journal.pone.0220799 · Cited by 35 · see citing works
SBIRT outcomes in Houston: Final report on InSight, a hospital district-based program for patients at risk for alcohol or drug use problems
The InSight Project Research Group (2009) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2009.00967.x · Cited by 34 · see citing works
Effect of two counseling interventions on self-reported alcohol consumption, alcohol biomarker phosphatidylethanol (PEth), and viral suppression among persons living with HIV (PWH) with unhealthy alcohol use in Uganda: A randomized controlled trial
Hahn, J. A., Fatch, R., Emenyonu, N. I., Sanyu, N., Katusiime, A., Levine, B., John Boscardin, W., Chander, G., Hutton, H., Camlin, C. S., et al. (2023) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2023.109783 · Cited by 22 · see citing works
Why do general practitioners not screen and intervene regarding alcohol consumption in Slovenia? A focus group study
Poplas Susič, T., Kersnik, J., & Kolšek, M. (2010) · Wiener klinische Wochenschrift · doi:10.1007/s00508-010-1335-z · Cited by 25 · see citing works
Perceived barriers by health care providers for screening and management of excessive alcohol use in an emergency department of a low-income country
Staton, C. A., Vissoci, J. R. N., Wojcik, R., Hirshon, J. M., Mvungi, M., Mmbaga, B. T., & Swahn, M. (2018) · Alcohol · doi:10.1016/j.alcohol.2018.01.003 · Cited by 22 · see citing works
What May Stimulate General Practitioners to Undertake Screening and Brief Intervention for Excess Alcohol Consumption in Slovenia? A Focus Group Study
Kersnik, J., Susič, T. P., Kolšek, M., & Švab, I. (2009) · Journal of International Medical Research · doi:10.1177/147323000903700534 · Cited by 24 · see citing works
Assessing for Alcohol Use Disorders in Women: Experiences of Advanced Practice Nurses in Primary Care Settings
Vandermause, R. K. (2007) · Journal of Addictions Nursing · doi:10.1080/10884600701699347 · Cited by 18 · see citing works
Implementation and Quality Improvement of a Screening and Counseling Program for Unhealthy Alcohol Use in an Academic General Internal Medicine Practice
Jonas, D. E., Miller, T., Ratner, S., McGuirt, B., Golin, C. E., Grodensky, C., Sturkie, E., Kinley, J., Dale, M., & Pignone, M. (2017) · Journal for Healthcare Quality · doi:10.1097/jhq.0000000000000069 · Cited by 16 · see citing works
Blended-eLearning Improves Alcohol Use Care in Kenya: Pragmatic Randomized Control Trial Results and Parallel Qualitative Study Implications
Clair, V., Musau, A., Mutiso, V., Tele, A., Atkinson, K., Rossa-Roccor, V., Bosire, E., Ndetei, D., & Frank, E. (2022) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-022-00841-x · Cited by 7 · see citing works
Étude pilote de l’entretien motivationnel chez des personnes condamnées pour conduite avec facultés affaiblies
Chanut, F., Dongier, M., Legault, L., Tremblay, J., Nadeau, L., Ouimet, M.-C., & Brown, T. G. (2008) · Drogues, santé et société · doi:10.7202/018041ar · Cited by 7 · see citing works
A Randomized Feasibility/Acceptability Trial of Acceptance and Commitment Therapy for People with HIV Who Drink at Unhealthy Levels.
Woolf-King, S. E., Dalton, M. R., Firkey, M., Sheinfil, A., Bucci, V., Estrada, B., Ramos, J., Hahn, J. A., Bricker, J., Gump, B., et al. (2026) · AIDS and Behavior · doi:10.1007/s10461-025-04990-7 · Cited by 1 · see citing works

Authors: Fleming, M. F.
Corresponding author: Fleming, Michael F.
ORCID: Fleming, Michael F.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 1997-04-02
Volume: 277
Issue: 13
Pages: 1039
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.1997.03540370029032
OpenAlex: W4294294187
Cited by: 538
References: 1
Citations by year: 2026: 4 · 2025: 2 · 2024: 8 · 2023: 6 · 2022: 5 · 2021: 7 · 2020: 7 · 2019: 7 · 2018: 11 · 2017: 10 · 2016: 12 · 2015: 15 · 2014: 15 · 2013: 14 · 2012: 21
FWCI: 27.37
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
Funders: National Institute on Alcohol Abuse and Alcoholism (AA08512-01A)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords: problem drinking, alcohol consumption reduction, physician counseling, binge drinking, excessive drinking, health care utilization, emergency department visits, hospitalization, primary care, alcohol screening, community-based primary care, gender differences

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Brief Physician Advice for Problem Alcohol Drinkers: A Randomized Controlled Trial in Community-Based Primary Care Practices

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks