Efficacy of Brief Interventions for Hazardous Drinkers in Primary Care: Systematic Review and Meta‐Analyses
Abstract
BACKGROUND: Because recent research in primary care has challenged the findings of previous reviews on the efficacy of brief interventions (BIs) on hazardous drinkers, we conducted a systematic review and meta-analysis to update the evidence of BIs as applied in the primary care setting. METHODS: We obtained source material by searching electronic databases and reference lists and hand-searching journals. We selected randomized trials providing frequency data that allowed assessment of the efficacy of BIs on an intention-to-treat basis. Results were summarized by the odds ratio (OR) of response. When appropriate, risk difference (RD) and its inverse (number needed to treat [NNT] to achieve a positive result) were also computed. Fixed and/or random effect models were fitted according to heterogeneity estimates. RESULTS: Thirteen studies provided data for a dose-effect analysis, 12 for comparison of BIs with reference categories. No clear evidence of a dose-effect relationship was found. BIs outperformed minimal interventions and usual care (random effects model OR = 1.55, 95% confidence interval [CI] = 1.27-1.90; RD = 0.11, 95% CI = 0.06-0.16; NNT = 10, 95% CI = 7-17). Similar results were obtained when two influential studies were removed (fixed effect model OR = 1.57, 95% CI = 1.32-1.87; RD = 0.11, 95% CI = 0.07-0.15; NNT = 9, 95% CI = 7-15). The heterogeneity between individual estimates was accounted for by the type of hazardous drinkers (heavy versus moderate) and by the characteristics of the included individuals (treatment seekers versus nontreatment seekers). The funnel plot did not show evidence of publication bias. CONCLUSION: Our results, although indicating smaller effect sizes than previous meta-analyses, do support the moderate efficacy of BIs. Further research is outlined.
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Alcohol screening and brief interventions in primary care settings are effective and cost-effective or cost-saving.
“In the past four decades, randomized controlled trials and meta-analyses have found alcohol SBI in primary care settings to be effective and cost-effective or cost-saving [6–13].”
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- Authors
- Ballesteros, J., Duffy, J. C., Querejeta, I., Ariño, J., & González‐Pinto, A.
- Affiliations
- Universidad de Deusto (ES)
- Corresponding author
- Ballesteros, Javier
- ORCID
- Ballesteros, Javier
- Venue
- Alcoholism: Clinical and Experimental Research
- Publisher
- Wiley
- Published
- 2004-04
- Volume
- 28
- Issue
- 4
- Pages
- 608-618
- ISSN
- 0145-6008 (ISSN-L)
- 1530-0277
- OpenAlex
- W2090438256
- Cited by
- 251
- References
- 34
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 4 · 2023: 6 · 2022: 5 · 2021: 9 · 2020: 8 · 2019: 3 · 2018: 4 · 2017: 15 · 2016: 9 · 2015: 12 · 2014: 19 · 2013: 15 · 2012: 19
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alcoholism Clinical and Experimental Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- brief intervention, hazardous drinking, primary care, alcoholism, treatment efficacy, heavy drinkers, moderate drinkers, usual care comparison, dose-response relationship
- MeSH terms
- Alcohol Drinking, Alcoholism, Humans, Primary Health Care, Confidence Intervals, Logistic Models, Odds Ratio
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