The effectiveness of brief alcohol interventions in primary care settings: A systematic review

KANER, EILEEN F. S.; DICKINSON, HEATHER O.; BEYER, FIONA; PIENAAR, ELIZABETH; SCHLESINGER, CARLA; CAMPBELL, FIONA; SAUNDERS, JOHN B.; BURNAND, BERNARD; HEATHER, NICK

doi:10.1111/j.1465-3362.2009.00071.x

Cited by 434Substance Abuse Treatment and OutcomesAlcohol Consumption and Health EffectsBehavioral Health and Interventions

The effectiveness of brief alcohol interventions in primary care settings: A systematic review

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KANER, EILEEN F. S., DICKINSON, HEATHER O., BEYER, FIONA, PIENAAR, ELIZABETH, SCHLESINGER, CARLA, CAMPBELL, FIONA, SAUNDERS, JOHN B., BURNAND, BERNARD +1 more·2009·Drug and Alcohol Review

DOI 10.1111/j.1465-3362.2009.00071.x

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Abstract

Issues. Numerous studies have reported that brief interventions delivered in primary care are effective in reducing excessive drinking. However, much of this work has been criticised for being clinically unrepresentative. This review aimed to assess the effectiveness of brief interventions in primary care and determine if outcomes differ between efficacy and effectiveness trials. Approach. A pre‐specified search strategy was used to search all relevant electronic databases up to 2006. We also hand‐searched the reference lists of key articles and reviews. We included randomised controlled trials (RCT) involving patients in primary care who were not seeking alcohol treatment and who received brief intervention. Two authors independently abstracted data and assessed trial quality. Random effects meta‐analyses, subgroup and sensitivity analyses and meta‐regression were conducted. Key Findings. The primary meta‐analysis included 22 RCT and evaluated outcomes in over 5800 patients. At 1 year follow up, patients receiving brief intervention had a significant reduction in alcohol consumption compared with controls [mean difference: −38 g week−1, 95%CI (confidence interval): −54 to −23], although there was substantial heterogeneity between trials (I 2 = 57%). Subgroup analysis confirmed the benefit of brief intervention in men but not in women. Extended intervention was associated with a non‐significantly increased reduction in alcohol consumption compared with brief intervention. There was no significant difference in effect sizes for efficacy and effectiveness trials. Conclusions. Brief interventions can reduce alcohol consumption in men, with benefit at a year after intervention, but they are unproven in women for whom there is insufficient research data. Longer counselling has little additional effect over brief intervention. The lack of differences in outcomes between efficacy and effectiveness trials suggests that the current literature is relevant to routine primary care. [Kaner EFS, Dickinson HO, Beyer F, Pienaar E, Schlesinger C, Campbell F, Saunders JB, Burnand B, Heather N. The effectiveness of brief alcohol interventions in primary care settings: A systematic review. Drug Alcohol Rev 2009;28:301–323]

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SBIRT is an evidence-based model for reduction in alcohol consumption in primary care health settings in the Western world.
“Screening, brief intervention, and referral for treatment (SBIRT) is an evidence-based model for reduction in alcohol consumption in primary care health settings in the Western world.”
From Effectiveness of Alcohol, Smoking, and Substance Involvement Screening Test-Linked Brief Intervention on Harmful and Hazardous Alcohol Use in Nigerian Semirural Communities: A Non-Randomized Intervention Study (2017) · cites this paper as [15]
There has been relatively robust evidence for the effectiveness of SBIRT for substance use, particularly unhealthy alcohol use.
“SBIRT for unhealthy drug use has been described in the scientific literature for over 50 years (19), and there has been relatively robust evidence for its effectiveness for substance use, particularly unhealthy alcohol use (20).”
From Community-Based Screening, Brief Intervention, and Referral for Treatment for Unhealthy Tobacco Use: Single Arm Study Experience and Implementation Success in Rural and Semi-Rural Settings, South-West Nigeria (2016) · cites this paper as [20]
University and ambulatory/primary care settings were the most effective in terms of magnitude of effect size.
“findings show that university and ambulatory/primary care settings were the most effective in terms of magnitude of effect size”
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 [14]
In outpatient medical care, brief intervention for reducing alcohol use has a weighted mean difference of -38.4.
“Compare the efficacy of BI for reducing alcohol use in outpatient medical care (weighted MD = -38.4) 6”
From Efficacy of Brief Intervention for Unhealthy Drug Use in Outpatient Medical Care: a Systematic Review and Meta-analysis (2022) · cites this paper as [6]
Brief intervention's effectiveness for reducing alcohol intake is well established.
“While evidence of BI for reducing alcohol intake is established, 6,10”
From Efficacy of Brief Intervention for Unhealthy Drug Use in Outpatient Medical Care: a Systematic Review and Meta-analysis (2022) · cites this paper as [6]

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Effectiveness of brief alcohol interventions in primary care populations
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Self-citation
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American Gastroenterological Association Institute Guideline on Initial Management of Acute Pancreatitis
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Self-citation
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Guidelines for Preventive Activities in General Practice
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Portion, package or tableware size for changing selection and consumption of food, alcohol and tobacco
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Efficacy of As-Needed Nalmefene in Alcohol-Dependent Patients with at Least a High Drinking Risk Level: Results from a Subgroup Analysis of Two Randomized Controlled 6-Month Studies
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Alcohol screening and brief intervention in primary care: Absence of evidence for efficacy in people with dependence or very heavy drinking
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Counselling for Alcohol Problems (CAP), a lay counsellor-delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial
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Specialty substance use disorder services following brief alcohol intervention: a meta-analysis of randomized controlled trials: SBI and referral to treatment
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“Although several systematic ormeta-analytical reviews have demonstrated the effectiveness of brief alcohol interventions in reducing alcohol consumption [23–25], the ability of SBI or SBIRT programs to increase the utilization of alcohol-related care needs further investigation.”
Treatment of alcoholic liver disease
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Self-citation
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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
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Self-citation
Alcohol and liver disease in Europe – Simple measures have the potential to prevent tens of thousands of premature deaths
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Reduction of drinking in problem drinkers and all-cause mortality
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Identification of Behavior Change Techniques and Engagement Strategies to Design a Smartphone App to Reduce Alcohol Consumption Using a Formal Consensus Method
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Primary care-based intervention to reduce at-risk drinking in older adults: a randomized controlled trial
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Single-Session Alcohol Interventions for Heavy Drinking College Students: A Systematic Review and Meta-Analysis
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Alcohol use of diabetes patients: the need for assessment and intervention
Engler, P. A., Ramsey, S. E., & Smith, R. J. (2010) · Acta Diabetologica · doi:10.1007/s00592-010-0200-x · Cited by 99 · see citing works
Screening and Brief Intervention for Unhealthy Drug Use in Primary Care Settings: Randomized Clinical Trials Are Needed
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A brief intervention for drug use, sexual risk behaviours and violence prevention with vulnerable women in South Africa: a randomised trial of the Women’s Health CoOp
Wechsberg, W. M., Jewkes, R., Novak, S. P., Kline, T., Myers, B., Browne, F. A., Carney, T., Morgan Lopez, A. A., & Parry, C. (2013) · BMJ Open · doi:10.1136/bmjopen-2013-002622 · Cited by 88 · see citing works
A Brief Patient Self-administered Substance Use Screening Tool for Primary Care: Two-site Validation Study of the Substance Use Brief Screen (SUBS)
McNeely, J., Strauss, S. M., Saitz, R., Cleland, C. M., Palamar, J. J., Rotrosen, J., & Gourevitch, M. N. (2015) · The American Journal of Medicine · doi:10.1016/j.amjmed.2015.02.007 · Cited by 87 · see citing works
The efficacy of a blended motivational interviewing and problem solving therapy intervention to reduce substance use among patients presenting for emergency services in South Africa: A randomized controlled trial
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Screening and brief interventions for hazardous and harmful alcohol use among patients with active tuberculosis attending primary public care clinics in South Africa: results from a cluster randomized controlled trial
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Effects of Screening, Brief Intervention, and Referral to Treatment (SBIRT) Education and Training on Nursing Students’ Attitudes toward Working with Patients who Use Alcohol and Drugs
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Sustained effectiveness and cost-effectiveness of Counselling for Alcohol Problems, a brief psychological treatment for harmful drinking in men, delivered by lay counsellors in primary care: 12-month follow-up of a randomised controlled trial
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Associations Between Medical Conditions and Alcohol Consumption Levels in an Adult Primary Care Population
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Frequent Binge Drinking After Combat-Acquired Traumatic Brain Injury Among Active Duty Military Personnel With a Past Year Combat Deployment
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2016 United Kingdom national guideline on the sexual health care of men who have sex with men
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A Randomized Clinical Trial of Mobile Phone Motivational Interviewing for Alcohol Use Problems in Kenya
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LONG-TERM EPIDEMIOLOGIC TRENDS OF STIs PRE- AND POST-PrEP INTRODUCTION: A NATIONAL TIME-SERIES ANALYSIS
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The relationship between services delivered and substance use outcomes in New Mexico's Screening, Brief Intervention, Referral and Treatment (SBIRT) Initiative
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Strategies to reduce alcohol-related harms and costs in Canada: A comparison of provincial policies
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Racial/ethnic and gender differences in receipt of brief intervention among patients with unhealthy alcohol use in the U.S. Veterans Health Administration
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Influence of Counselor Characteristics and Behaviors on the Efficacy of a Brief Motivational Intervention for Heavy Drinking in Young Men-A Randomized Controlled Trial
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BackgroundInfluential
BRIEF ALCOHOL INTERVENTION: TIME FOR TRANSLATIONAL RESEARCH
Kaner, E. (2010) · Addiction · doi:10.1111/j.1360-0443.2009.02848.x · Cited by 47 · see citing works
Self-citation
HIV primary care providers—Screening, knowledge, attitudes and behaviors related to alcohol interventions
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Pharmacists' knowledge, attitudes and beliefs regarding screening and brief intervention for prescription opioid abuse: a survey of Utah and Texas pharmacists
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A randomized study of the use of screening, brief intervention, and referral to treatment (SBIRT) for drug and alcohol use with jail inmates
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Testing the Initial Efficacy of a Mailed Screening and Brief Feedback Intervention to Reduce At‐Risk Drinking in Middle‐Aged and Older Adults: The Comorbidity Alcohol Risk Evaluation Study
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Effectiveness of brief alcohol interventions in primary care populations
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Alcohol Brief Intervention in Primary Care: A Systematic Review
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Authors: KANER, E. F. S., DICKINSON, H. O., BEYER, F., PIENAAR, E., SCHLESINGER, C., CAMPBELL, F., SAUNDERS, J. B., BURNAND, B., & HEATHER, N.
Affiliations: Newcastle University (GB)
University of Sheffield (GB)
The University of Sydney (AU)
University of Lausanne (CH)
Northumbria University (GB)
Corresponding author: KANER, EILEEN F. S.
ORCID: KANER, EILEEN F. S.
BEYER, FIONA
PIENAAR, ELIZABETH
CAMPBELL, FIONA
SAUNDERS, JOHN B.
BURNAND, BERNARD
HEATHER, NICK
Venue: Drug and Alcohol Review
Publisher: Wiley
Published: 2009-05
Volume: 28
Issue: 3
Pages: 301-323
ISSN: 0959-5236 (ISSN-L)
1465-3362
DOI: 10.1111/j.1465-3362.2009.00071.x
OpenAlex: W1850472950
Cited by: 434
References: 91
Citations by year: 2026: 6 · 2025: 17 · 2024: 6 · 2023: 15 · 2022: 13 · 2021: 23 · 2020: 16 · 2019: 18 · 2018: 33 · 2017: 28 · 2016: 34 · 2015: 47 · 2014: 50 · 2013: 43 · 2012: 34
FWCI: 3.47
Type: journal article
Language: en
Open access: green
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 4 d)
Locations: Drug and Alcohol Review (publishedVersion)
PubMed (publishedVersion)
IRIS (submittedVersion)
Northumbria Research Link (Northumbria University) (submittedVersion)
SERVAL (Université de Lausanne) (submittedVersion)
Newcastle University ePrints (Newcastle Univesity)
Funders: Newcastle University
Economic and Social Research Council (ES/G007470/1)
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 alcohol intervention, excessive drinking, alcohol consumption reduction, primary care, sex differences, usual care
MeSH terms: Alcohol Drinking, Alcoholism, Humans, Primary Health Care, Psychotherapy, Brief, Sex Characteristics, Randomized Controlled Trials as Topic

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The effectiveness of brief alcohol interventions in primary care settings: A systematic review

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