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
Abstract
AIMS: The extent of variation attributable to regional differences for the efficacy of brief intervention (BI) to reduce hazardous and harmful alcohol consumption is unclear. The primary aim of this study was to determine overall efficacy of BI at 6- and 12-month follow-up in primary health care (PHC) and emergency department (ED) studies. The secondary aim was to examine whether variance in study outcome can be explained by the geographical region in which trials have taken place (European versus non-European). METHODS: A systematic review and meta-analysis of randomized controlled trials (RCTs) published before August 2014 was undertaken. Twenty RCTs conducted in PHC settings with a total of 8226 participants (European = 4564/non-European = 3662) and eight RCTs conducted in ED settings with a total of 4799 participants (European = 2465/non-European = 2334) were eligible. Primary outcome measure was reduction in grams of alcohol consumed per week for BI and control groups at 6- and 12-month follow-up. An inverse variance model was applied to measure the effect of treatment in mean differences for BI and control groups at 6- and 12-month follow-up. Variance between study outcomes was explored using subgroup analysis of European versus non-European countries. RESULTS: For PHC trials at 6-month follow-up, statistically significant benefits of BI were indicated [mean difference (MD) = -21.98 g/week; 95% confidence interval (CI) = -37.40 to -6.57; P = 0.005]. At 12-month follow-up, statistically significant benefit of BI was evident (MD = -30.86 g/week; 95% CI = -46.49 to -15.23; P = 0.0001). For ED trials at 6-month follow-up, statistically significant benefits of BI were indicated (MD = -17.97 g/week; 95% CI = -29.69 to -6.24; P = .003). At 12-month follow-up, statistically significant benefit in favour of BI was evident (MD = -18.21 g/week; 95% CI = -26.71 to -9.70; P < 0.0001). No statistically significant differences were detected in subgroup analyses of outcomes for European versus non-European studies. CONCLUSIONS: Brief intervention (BI) to reduce alcohol consumption is associated with reducing grams of alcohol consumed per week among hazardous and harmful drinkers at 6- and 12-month follow-up in primary health care and emergency department trials. The geographical region in which trials are undertaken does not appear to explain the variance in trial outcomes for reducing alcohol consumption.
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A myriad of other high-income country studies have shown that a brief intervention administered specifically in an emergency department setting can reduce harmful alcohol use and its consequences up to 12 months post-injury and decrease the incidence of trauma recidivism.
“A myriad of other high-income country (HIC) studies have shown that a BI administered specifically in an emergency department setting can reduce harmful alcohol use and its consequences up to 12 months post-injury [16–19] and decrease the incidence of trauma recidivism [20].”
Brief interventions have been studied to decrease alcohol use and alcohol-related consequences in a variety of settings and countries.
“Brief interventions have been studied to decrease alcohol use and alcohol-related consequences in a variety of settings and countries [102–105].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [103]
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“Previous literature has explored the efficacy of BIs and pragmatic randomized clinical trials in either high-income countries or in primary care settings [14,35–37].”
- Authors
- Elzerbi, C., Donoghue, K., & Drummond, C.
- Affiliations
- National Addiction Centre, Addictions Department King's College London London UK
- King's College London (GB)
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2015-06-12
- Volume
- 110
- Issue
- 7
- Pages
- 1082-1091
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- OpenAlex
- W2107849015
- Cited by
- 64
- References
- 80
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 2 · 2023: 14 · 2022: 10 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 7 · 2017: 6 · 2016: 7
- FWCI
- 0.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- South London and Maudsley NHS Foundation Trust
- National Institute for Health and Care Research (RP-PG-0609-10162, 13/86/03, HTA/13/86/03)
- NIHR Collaboration for Leadership in Applied Health Research and Care South London
- Collaboration for Leadership in Applied Health Research and Care - Greater Manchester
- 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, alcohol consumption reduction, primary care, emergency department, alcohol use disorder prevention
- MeSH terms
- Adolescent, Adult, Alcohol Drinking, Emergency Service, Hospital, Europe, Female, Follow-Up Studies, Humans, Male, Middle Aged, Primary Health Care, Randomized Controlled Trials as Topic, Treatment Outcome, Young Adult
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 ›
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