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Cited by 648Substance Abuse Treatment and OutcomesAlcohol Consumption and Health EffectsBehavioral Health and Interventions

Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption

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Wallace, P., Cutler, S., Haines, A.·1988·BMJ
DOI 10.1136/bmj.297.6649.663PMC PMC1834369
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Abstract

OBJECTIVE: To determine effectiveness of advice from general practitioners to heavy drinkers to reduce their excessive alcohol consumption (35 U or more a week for men, 21 U or more for women). DESIGN: Randomised, controlled double blind trial over 12 months with interim assessment at six months. SETTING: Group practices (n = 47; list size averaging 10,000) recruited from Medical Research Council's general practice research framework, mostly in rural or small urban settings. PATIENTS: Patients recruited after questionnaire survey. Of total of 2571 (61.2%) of 4203 patients invited for interview who attended, 909 (35.4%) stated that in past seven days they had drunk above the limits set for study and had not received advice; they were randomised to control and treatment groups. INTERVENTIONS: Patients in treatment group were interviewed by general practitioner (who had had a training session) and received advice and information about how to reduce consumption and also given a drinking diary. END POINT: Study aimed at detecting a reduction in proportion of men with excessive alcohol consumption of 30% in treatment group and 20% in control group (for women 40% and 20%, respectively) with a power of 90% at 5% level of significance. In addition, corroborative measures such as estimation of gamma-glutamyltransferase activity were included. MEASUREMENTS AND MAIN RESULTS: At one year a mean reduction in consumption of alcohol of 18.2 (SE 1.5) U/week had occurred in treated men compared with a reduction of 8.1 (1.6) U/week in controls (p less than 0.001). The proportion of men with excessive consumption at interview had dropped by 43.7% in the treatment group compared with 25.5% in controls (p less than 0.001). A mean reduction in weekly consumption of 11.5 (1.6) U occurred in treated women compared with 6.3 (2.0) U in controls (p less than 0.05), with proportionate reductions of excessive drinkers in treatment and control groups of 47.7% and 29.2% respectively. Reduction in consumption increased significantly with number of general practitioner interventions. At one year the mean value for gamma-glutamyltransferase activity had dropped significantly more in treated men (-2.4 (0.9)IU/l) than in controls (+1.1(1.0)IU/l; t = 2.7, p less than 0.01). Reduction in gamma-glutamyltransferase activity tended to increase with number of intervention sessions in men. Changes in gamma-glutamyltransferase activity in women and changes in other indicators in both sexes did not differ significantly between treatment and control groups. CONCLUSIONS: If the results of this study were applied to the United Kingdom intervention by general practitioners could each year reduce to moderate levels the alcohol consumption of some 250000 men and 67500 women who currently drink to excess. General practitioners and other members of the primary health care team should therefore be encouraged to include counselling about alcohol consumption in their preventive activities.

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Authors
Wallace, P., Cutler, S., & Haines, A.
Affiliations
Northwick Park Hospital (GB)
ORCID
Venue
BMJ
Publisher
BMJ
Published
1988-09-10
Volume
297
Issue
6649
Pages
663-668
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.297.6649.663
PMC
PMC1834369
OpenAlex
W2024601247
Semantic Scholar
510a095e09b327a2a2bf3bc47ad3cc209eb74c63
Cited by
648
References
23
Citations by year
2025: 2 · 2024: 4 · 2023: 3 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 7 · 2018: 5 · 2017: 13 · 2016: 9 · 2015: 8 · 2014: 10 · 2013: 13 · 2012: 17
FWCI
18.93
Type
journal article
Language
en
Open access
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations
  • BMJ (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Merck Sharp and Dohme
  • Medical Research Council
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
excessive alcohol consumption, heavy drinking, general practitioner advice, alcohol reduction interventions, gamma-glutamyl transferase, alcohol consumption reduction, primary care, sex differences in drinking, intervention effectiveness, alcohol screening and brief intervention, alcohol and cancer risk
MeSH terms
Adolescent, Adult, Aged, Alcoholism, Attitude of Health Personnel, Attitude to Health, Clinical Trials as Topic, Double-Blind Method, England, Family Practice, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Patient Education as Topic, Physician-Patient Relations, Prognosis, Random Allocation, Time Factors

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