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The effectiveness of brief alcohol interventions in primary care settings: A systematic review
Open accessAbstract
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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In the citing paper
“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.”
In the citing paper
“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).”
In the citing paper
“findings show that university and ambulatory/primary care settings were the most effective in terms of magnitude of effect size”
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“Unhealthy alcohol use BI is moderately efficacious, reducing alcohol ranging between 23 and 54 less grams per week at 1-year follow-up. 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]
In the citing paper
“Many outpatient medical care facilities across the globe have dedicated resources 7 -9 to implementing SBI for early detection and early intervention. 5,6”
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]
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Metadata
- 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
- Venue
- Drug and Alcohol Review
- Publisher
- Wiley
- Published
- 2009-05
- Volume
- 28
- Issue
- 3
- Pages
- 301-323
- ISSN
- 0959-5236 (ISSN-L)
- 1465-3362
- 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
- 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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