Should brief interventions in primary care address alcohol problems more strongly?

McCambridge, Jim; Rollnick, Stephen

doi:10.1111/add.12388

Cited by 53Substance Abuse Treatment and OutcomesAlcohol Consumption and Health EffectsBehavioral Health and Interventions

Should brief interventions in primary care address alcohol problems more strongly?

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McCambridge, Jim, Rollnick, Stephen·2014·Addiction

DOI 10.1111/add.12388PMC PMC4153955

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BACKGROUND: Brief interventions have well-established small effects on alcohol consumption among hazardous and harmful drinkers in primary care, and national large-scale programmes are being implemented in many countries for public health reasons. METHODS: This paper examines data from reviews and draws upon older brief intervention studies and recent developments in the literature on motivational interviewing to consider the capacity of brief interventions to benefit those with problems, including those with severe problems. RESULTS: Effects on alcohol problems have been shown much less consistently, and evidence cannot be claimed to be strong for any outcomes other than reduced consumption. Combinations of advice and motivational interviewing are a promising target for evaluation in trials, and more detailed studies of the conduct of brief interventions are needed. CONCLUSIONS: We propose that brief interventions in primary care may be more effective if they offer appropriate content in a person-centred manner, addressing patient concerns more directly.

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Existing systematic reviews have found variability in effect by duration of intervention or number of visits, but have not taken into account differences in content or provider.
“Existing systematic reviews have found variability in effect by duration of intervention or number of visits, but this has not taken into account differences in content or provider.6–10”
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 [8]

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(1991) · Medical Entomology and Zoology · Cited by 4,438 · see citing works
Physician advice for smoking cessation
Stead, L. F., Buitrago, D., Preciado, N., Sanchez, G., Hartmann-Boyce, J., & Lancaster, T. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000165.pub4 · Cited by 1,955 · see citing works
Motivational interviewing: a systematic review and meta-analysis.
Rubak, S., Sandbæk, A., Lauritzen, T., & Christensen, B. (2005) · Europe PMC (PubMed Central) · Cited by 1,855 · 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 review
BIEN, T. H., MILLER, W. R., & TONIGAN, J. S. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb00820.x · Cited by 1,577 · see citing works
Pharmacological interventions for smoking cessation: an overview and network meta-analysis
Cahill, K., Stevens, S., Perera, R., & Lancaster, T. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009329.pub2 · Cited by 1,243 · 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
Effect of general practitioners' advice against smoking
Russell, M. A., Wilson, C., Taylor, C., & Baker, C. D. (1979) · BMJ · doi:10.1136/bmj.2.6184.231 · Cited by 918 · 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
Assessing competence in the use of motivational interviewing
Moyers, T. B., Martin, T., Manuel, J. K., Hendrickson, S. M. L., & Miller, W. R. (2005) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2004.11.001 · Cited by 738 · see citing works
Matching Alcoholism Treatments to Client Heterogeneity: Project MATCH Three‐Year Drinking Outcomes
Project MATCH Research Group (1998) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1998.tb03912.x · Cited by 576 · see citing works
The effectiveness and applicability of motivational interviewing: a practice‐friendly review of four meta‐analyses
Lundahl, B., & Burke, B. L. (2009) · Journal of Clinical Psychology · doi:10.1002/jclp.20638 · Cited by 573 · see citing works
Negotiating behaviour change in medical settings: the development of brief motivational interviewing
Rollnick, S., Heather, N., & Bell, A. (1992) · Journal of Mental Health · doi:10.3109/09638239209034509 · Cited by 537 · see citing works
Self-citation
Alcohol consumption and related problems among primary health care patients: WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption—I
SAUNDERS, J. B., AASLAND, O. G., AMUNDSEN, A., & GRANT, M. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb00822.x · Cited by 480 · see citing works
Multiple behavioral risk factor interventions in primary care
Goldstein, M. G., Whitlock, E. P., & DePue, J. (2004) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2004.04.023 · Cited by 467 · see citing works
Motivational Interviewing with Problem Drinkers: II. The Drinker's Check-up as a Preventive Intervention
Miller, W. R., Sovereign, R. G., & Krege, B. (1988) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s0141347300014129 · Cited by 334 · see citing works
How does motivational interviewing work? Therapist interpersonal skill predicts client involvement within motivational interviewing sessions.
Moyers, T. B., Miller, W. R., & Hendrickson, S. M. L. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.4.590 · Cited by 327 · see citing works
A cross-national trial of brief interventions with heavy drinkers. WHO Brief Intervention Study Group.
(1996) · American Journal of Public Health · doi:10.2105/ajph.86.7.948 · Cited by 314 · see citing works
Identification of behaviour change techniques to reduce excessive alcohol consumption
Michie, S., Whittington, C., Hamoudi, Z., Zarnani, F., Tober, G., & West, R. (2012) · Addiction · doi:10.1111/j.1360-0443.2012.03845.x · Cited by 288 · see citing works
Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial
Kaner, E., Bland, M., Cassidy, P., Coulton, S., Dale, V., Deluca, P., Gilvarry, E., Godfrey, C., Heather, N., Myles, J., et al. (2013) · BMJ · doi:10.1136/bmj.e8501 · Cited by 277 · cited 1× · see citing works
“One hour of training was provided to deliver advice in the SIPS primary care trial, which may be insufficient to be effective [47].”
Background
Rethinking Substance Abuse: What the Science Shows, and What We Should Do About It
Woolf, S. E., & Maisto, S. A. (2007) · Addiction · doi:10.1111/j.1360-0443.2007.02022_1.x · Cited by 273 · see citing works
Therapist influence on client language during motivational interviewing sessions
Moyers, T. B., & Martin, T. (2006) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2005.12.003 · Cited by 248 · 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
Alcohol‐Related Problems in the Primary Health Care Setting: a review of early intervention strategies
Babor, T. F., Ritson, E. B., & HODGSON, R. J. (1986) · British Journal of Addiction · doi:10.1111/j.1360-0443.1986.tb00291.x · Cited by 217 · see citing works
Biomedical risk assessment as an aid for smoking cessation
Bize, R., Burnand, B., Mueller, Y. K., Rège-Walther, M., Camain, J.-Y., & Cornuz, J. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004705.pub4 · Cited by 182 · see citing works
Stage-based interventions for smoking cessation
Cahill, K., Lancaster, T., & Green, N. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004492.pub4 · Cited by 174 · see citing works
Brief alcohol intervention—where to from here? Challenges remain for research and practice
Nilsén, P. (2010) · Addiction · doi:10.1111/j.1360-0443.2009.02779.x · Cited by 166 · see citing works
Motivational Interviewing: Helping People Change, 3rd Edition
Miller, W. R., & Rollnick, S. (2012) · Cited by 155 · see citing works
Self-citation
ESTABLISHING TREATMENT RELATIONS WITH ALCOHOLICS
Chafetz, M. E., Blane, H. T., Abram, H. S., Golner, J. H., LACY, E., McCourt, W. F., Clark, E., & Meyers, W. R. (1962) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-196205000-00001 · Cited by 148 · see citing works
Training practitioners to deliver opportunistic multiple behaviour change counselling in primary care: a cluster randomised trial
Butler, C., Simpson, S. A., Hood, K., Cohen, D. R., Pickles, T., Spanou, C., McCambridge, J., Moore, L., Randell, E., Alam, M. F., et al. (2013) · BMJ · doi:10.1136/bmj.f1191 · Cited by 136 · see citing works
Self-citation
On-line Randomized Controlled Trial of an Internet Based Psychologically Enhanced Intervention for People with Hazardous Alcohol Consumption
Wallace, P., Murray, E., McCambridge, J., Khadjesari, Z., White, I. R., Thompson, S. G., Kalaitzaki, E., Godfrey, C., & Linke, S. (2011) · PLoS ONE · doi:10.1371/journal.pone.0014740 · Cited by 114 · cited 1× · see citing works
“On-line trials indicate that large numbers of people are prepared to seek help with alcohol [52], and it remains to be established what role primary care has in delivering these interventions in the era of the internet.”
BackgroundSelf-citation
Randomized controlled trial of motivational interviewing compared with drug information and advice for early intervention among young cannabis users
McCambridge, J., Slym, R. L., & Strang, J. (2008) · Addiction · doi:10.1111/j.1360-0443.2008.02331.x · Cited by 107 · see citing works
Self-citation
Alcohol and drug treatment systems in public health perspective: mediators and moderators of population effects
Babor, T. F., Stenius, K., & Romelsjo, A. (2008) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.249 · Cited by 97 · cited 1× · see citing works
“In the alcohol field, the need to rethink the role of specialist services within the health-care system is well recognized [32,33].”
Background
Can screening and brief intervention lead to population-level reductions in alcohol-related harm?
Heather, N. (2012) · Addiction Science & Clinical Practice · doi:10.1186/1940-0640-7-15 · Cited by 83 · see citing works
Specialist versus general practitioner treatment of problem drinkers
Drummond, C., Thom, B., Brown, C., Edwards, G., & MULLAN, M. J. (1990) · The Lancet · doi:10.1016/0140-6736(90)92279-q · Cited by 70 · see citing works
A Systematic Review and Meta-Analysis of Health Care Utilization Outcomes in Alcohol Screening and Brief Intervention Trials
Bray, J. W., Cowell, A. J., & Hinde, J. M. (2011) · Medical Care · doi:10.1097/mlr.0b013e318203624f · Cited by 65 · see citing works
Does change talk during brief motivational interventions with young men predict change in alcohol use?
Gaume, J., Bertholet, N., Faouzi, M., Gmel, G. E., & Daeppen, J. (2012) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2012.04.005 · Cited by 51 · see citing works
Development of a structured generic drug intervention model for public health purposes: a brief application of motivational interviewing with young people
McCambridge, J., & Strang, J. (2003) · Drug and Alcohol Review · doi:10.1080/09595230310001613903 · Cited by 43 · see citing works
Self-citation
Breaking new ground in the study and practice of alcohol brief interventions
Heather, N. (2010) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2010.00204.x · Cited by 42 · see citing works
Do brief interventions which target alcohol consumption also reduce cigarette smoking?
McCambridge, J., & Jenkins, R. J. (2008) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2008.03.011 · Cited by 32 · see citing works
Self-citation
What process research tells us about brief intervention efficacy
Daeppen, J., Bertholet, N., & Gaume, J. (2010) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2010.00235.x · Cited by 29 · see citing works
Brief intervention content matters
McCambridge, J. (2013) · Drug and Alcohol Review · doi:10.1111/dar.12044 · Cited by 28 · see citing works
Self-citation
Developing, evaluating and implementing alcohol brief interventions in Europe
Heather, N. (2011) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2010.00267.x · Cited by 27 · see citing works
Fifty years of brief intervention effectiveness trials for heavy drinkers: Editorial
McCAMBRIDGE, J. (2011) · Drug and Alcohol Review · doi:10.1111/j.1465-3362.2011.00379.x · Cited by 24 · see citing works
Self-citation
When is it appropriate to address patients' alcohol consumption in health care—national survey of views of the general population in Sweden
Nilsén, P., Bendtsen, P., McCambridge, J., Karlsson, N. E., & Dalal, K. (2012) · Addictive Behaviors · doi:10.1016/j.addbeh.2012.05.024 · Cited by 23 · see citing works
Self-citation
Brief Alcohol Intervention in Medical Settings:Concerns from the Consulting Room
Rollnick, S., Butler, C., & HODGSON, R. J. (1997) · Addiction Research & Theory · doi:10.3109/16066359709004347 · Cited by 22 · see citing works
Self-citation
ESTABLISHING TREATMENT RELATIONS WITH ALCOHOLICS
Chafetz, M. E., Blane, H. T., ABRAM, H. S., Clark, E., Golner, J. H., HASTHE, E. L., & McCourt, W. F. (1964) · The Journal of Nervous and Mental Disease · doi:10.1097/00005053-196404000-00010 · Cited by 17 · see citing works
Stage-based interventions for smoking cessation
Cahill, K., & Green, N. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004492.pub3 · Cited by 15 · see citing works
Early Intervention Among Excessive Drinkers: How Early and in What Context?
Rollnick, S. (1987) · Australian Drug and Alcohol Review · doi:10.1080/09595238780000811 · Cited by 11 · see citing works
Self-citation
A comparison of doctors' practice in notifying addicts to the Home Office and reporting them to the North Western Drug Misuse Database
Mott, J., Caddle, D., & Donmall, M. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb00808.x · Cited by 7 · see citing works
General practitioner screening for excessive alcohol use
Rollnick, S. (2003) · BMJ · doi:10.1136/bmj.326.7384.336 · Cited by 4 · see citing works
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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
Validation of the AUDIT-C in adults seeking help with their drinking online
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Patel, V., Weobong, B., Nadkarni, A., Weiss, H. A., Anand, A., Naik, S., Bhat, B., Pereira, J., Araya, R., Dimidjian, S., et al. (2014) · Trials · doi:10.1186/1745-6215-15-101 · Cited by 66 · see citing works
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Cole, B., Clark, D. C., Seale, J. P., Shellenberger, S., Lyme, A., Johnson, J. A., & Chhabria, A. (2012) · Substance Abuse · doi:10.1080/08897077.2011.639696 · Cited by 31 · see citing works
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Wagner, A. J., Garbers, R., Lang, A., Borgert, A. J., & Fisher, M. G. (2016) · Journal of Trauma Nursing · doi:10.1097/jtn.0000000000000200 · Cited by 5 · see citing works
Quik fix: A randomized controlled trial of an enhanced brief motivational interviewing intervention for alcohol/cannabis and psychological distress in young people [Letter to the Editor]
Hides, L. M., Carroll, S., Scott, R., et al. (2013) · QUT ePrints (Queensland University of Technology)

Authors: McCambridge, J., & Rollnick, S.
Affiliations: London School of Hygiene & Tropical Medicine (GB)
Cardiff University (GB)
Corresponding author: McCambridge, Jim
ORCID: McCambridge, Jim
Rollnick, Stephen
Venue: Addiction
Publisher: Wiley
Published: 2013-11-22
Volume: 109
Issue: 7
Pages: 1054-1058
ISSN: 0965-2140 (ISSN-L)
1360-0443
DOI: 10.1111/add.12388
PMC: PMC4153955
OpenAlex: W2160490405
Cited by: 53
References: 51
Citations by year: 2025: 2 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 7 · 2020: 4 · 2019: 3 · 2018: 6 · 2017: 5 · 2016: 5 · 2015: 8 · 2014: 6 · 2013: 1
FWCI: 0.79
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/3.0/ (vor)
Locations: Addiction (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
ORCA Online Research @Cardiff (Cardiff University) (submittedVersion)
Funders: Wellcome Trust (WT086516MA)
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, alcohol problems, primary care, motivational interviewing, alcohol consumption, hazardous drinking, person-centred care, public health programs
MeSH terms: Alcoholism, Humans, Primary Health Care, Motivational Interviewing

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