Rethinking brief interventions for alcohol in general practice
Open accessAbstract
Jim McCambridge and Richard Saitz question the effectiveness of brief advice and counselling in primary care to prevent harm from heavy alcohol use and call for a more strategic approach
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Brief intervention (BI) is an evidence-based measure for alcohol problems.
“One such evidence based measure is brief intervention (BI) for alcohol problems”
From Brief interventions for alcohol use disorders in low- and middle-income countries: barriers and potential solutions (2022) · cites this paper as [24]
The introduction says evidence suggests brief interventions can be effective for alcohol use. But the section ‘Evidence of effectiveness evidence is weak’ says that effectiveness inferences are not secure and that reported reductions in alcohol-related problems were based on self-reported consumption instead. The source therefore supports an evidence base for brief interventions, but not the unqualified claim that they are an evidence-based measure for alcohol problems. (LLM, conf=0.86)
Experimental — accuracy not yet measuredBIs for alcohol use disorders have been extensively researched over the last four decades, with a large body of evidence indicating their efficacy in primary care and emergency care.
“BIs for alcohol use disorders (AUDs) have been extensively researched over the last four decades [20, 23, 24], with a large body of evidence indicating their efficacy in primary care and emergency care.”
From Brief interventions for alcohol use disorders in low- and middle-income countries: barriers and potential solutions (2022) · cites this paper as [24]
The “Evidence of effectiveness evidence is weak” section describes a substantial body of brief-intervention trials and reports a review finding reduced drinking in primary-care populations. But the authors distinguish trial efficacy from real-world effectiveness, note that recent large general-practice trials found no benefit, and do not establish efficacy for people with alcohol use disorders in both primary and emergency care. The claim presents the evidence more broadly and confidently than this paper does. (LLM, conf=0.85)
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Rosário, F., Santos, M. I., Angus, K., Pas, L., Ribeiro, C., & Fitzgerald, N. (2021) · Implementation Science · doi:10.1186/s13012-020-01073-0 · Cited by 141 · see citing works
“Notwithstanding recent debates questioning SBI effectiveness [25, 26], these represent missed opportunities to increase patients’ awareness of alcohol-related risks, a first step towards enabling them to make a more informed choice on whether or not to cut down [4].”
BackgroundNadkarni, A., Weiss, H. A., Weobong, B., McDaid, D., Singla, D. R., Park, A.-L., Bhat, B., Katti, B., McCambridge, J., Murthy, P., et al. (2017) · PLOS Medicine · doi:10.1371/journal.pmed.1002386 · Cited by 80 · see citing works
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“Some of this is a consequence of the mixed evidence about the effectiveness of BI- some encouraging [30, 43], other less so [24].”
BackgroundMethodHahn, J. A., Fatch, R., Emenyonu, N. I., Sanyu, N., Katusiime, A., Levine, B., John Boscardin, W., Chander, G., Hutton, H., Camlin, C. S., et al. (2023) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2023.109783 · Cited by 22 · see citing works
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- Authors
- McCambridge, J., & Saitz, R.
- Affiliations
- University of York (GB)
- Boston University (US)
- Corresponding author
- McCambridge, Jim
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2017-01-20
- Volume
- 356
- Pages
- j116
- ISSN
- 1756-1833 (ISSN-L)
- 0959-8138
- OpenAlex
- W2572022266
- Cited by
- 146
- References
- 35
- Citations by year
- 2026: 1 · 2025: 10 · 2024: 11 · 2023: 20 · 2022: 17 · 2021: 23 · 2020: 13 · 2019: 12 · 2018: 18 · 2017: 21
- FWCI
- 13.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Centers for Disease Control and Prevention
- Substance Abuse and Mental Health Services Administration
- Health Resources and Services Administration
- Menzies Centre for Australian Studies, King's College London, University of London
- 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 consumption, general practice, primary care, alcohol counseling, heavy drinking, alcohol harm prevention, intervention effectiveness
- MeSH terms
- Alcohol Drinking, Counseling, Humans, Treatment Outcome, Evidence-Based Medicine, General Practice
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