Screening and brief interventions for hazardous and harmful alcohol use among hospital outpatients in South Africa: results from a randomized controlled trial
Open accessAbstract
BACKGROUND: High prevalence rates of hazardous and harmful alcohol use have been found in a hospital outpatient setting in South Africa. Hospital settings are a particularly valuable point of contact for the delivery of brief interventions because of the large access to patient populations each year. With this in mind, the primary purpose of this randomized controlled trial is to provide screening for alcohol misuse and to test the effectiveness of brief interventions in reducing alcohol intake among hospital outpatients in South Africa. METHODS: The study design for this effectiveness study is a randomized controlled trial with 6- and 12-month follow-ups to examine the effects of a brief alcohol intervention to reduce alcohol use by hazardous or harmful drinkers in a hospital setting. Outpatients were screened for alcohol problems, and those identified as hazardous or harmful drinkers were randomized into an experimental or control group. The experimental group received one brief counselling session on alcohol risk reduction, while the control group received a health education leaflet. RESULTS: Of the 1419 screened for alcohol misuse who agreed to participate in the trial 392 (27.6%) screened positive for hazardous or harmful use on the Alcohol Use Disorder Identification Test (AUDIT) (score 7/8-19) and 51 (3.6%) had an AUDIT score of 20 or more. Among the 282 (72%) hospital outpatients who also attended the 12-month follow-up session, the time effects on the AUDIT scores were significant [F (1,195 = 7.72), P < 0.01] but the intervention effect on the AUDIT score was statistically not significant [F (1,194 = 0.06), P < 0.804]. CONCLUSION: Given the lack of difference in outcome between control and intervention group, alcohol screening and the provision of an alcohol health education leaflet may in itself cause reduction in drinking. TRIAL REGISTRATION: PACTR201110000319392.
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Single-session brief interventions resulted in reduced alcohol use at 3 months.
“Concerning alcohol use, single session BI resulted in reduced use at month 1 [50,54]; 6 weeks [72], 3 months [50,61–64], and 6 months [50,52,60,72].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [64]
The Methods describe a one-session, 20-minute intervention, and the Results report reduced alcohol-use scores over time in both the intervention and control groups. But the Methods specify assessments at 6 and 12 months, not 3 months, and the Results find no statistically significant effect attributable to the intervention compared with control. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSome studies reported no intervention effect on alcohol use at month 12.
“Other studies reported no intervention effect on alcohol use at month 3 [44], month 5 [58], month 6 [59,64,68] and month 12 [58,64].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [64]
Some studies reported no intervention effect on alcohol use at month 6.
“Other studies reported no intervention effect on alcohol use at month 3 [44], month 5 [58], month 6 [59,64,68] and month 12 [58,64].”
From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [64]
Some studies found a similar reduction in alcohol-related outcomes between both intervention and control groups (null effect).
“However, there were some studies that found a similar reduction in alcohol-related outcomes between both the intervention and control groups, thus a null effect [22,28,30,79,80,82,88].”
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 [80]
Brief interventions at the primary care setting addressing alcohol and other substances reduced alcohol use for both intervention and control arms equally.
“Assangkornchai and Pengpid found brief interventions at the primary care setting addressing alcohol and other substances reduced alcohol use for both intervention and control arms equally [28,80,82].”
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 [80]
In the systematic review, 6 studies evaluated brief interventions in South Africa.
“In our systematic review, 6 studies evaluated brief interventions in South Africa [67,79–81,93,94].”
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 [80]
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Asiakkaan kokemus alkoholin käytön mini-interventiosta
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- Authors
- Pengpid, S., Peltzer, K., Skaal, L., & Van der Heever, H.
- Affiliations
- Mahidol University (TH)
- Human Sciences Research Council (ZA)
- Sefako Makgatho Health Sciences University (ZA)
- Corresponding author
- Pengpid, Supa
- Venue
- BMC Public Health
- Published
- 2013-07-11
- Volume
- 13
- Issue
- 1
- Pages
- 644-644
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC3849548
- OpenAlex
- W1971026092
- Cited by
- 49
- References
- 58
- Citations by year
- 2025: 4 · 2024: 3 · 2023: 5 · 2022: 7 · 2021: 5 · 2020: 4 · 2019: 4 · 2017: 3 · 2016: 4 · 2015: 4 · 2014: 5 · 2013: 1
- FWCI
- 3.41
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Vlaamse Interuniversitaire Raad
- VLIRUOS
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Keywords
- hazardous drinking, alcohol screening, brief intervention, hospital outpatients, alcohol counseling, health education leaflets, auditing, South Africa
- MeSH terms
- Adult, Alcohol Drinking, Ethanol, Alcoholism, Counseling, Female, Health Education, Hospitals, Humans, Male, Outpatients, South Africa, Risk Reduction Behavior, Young Adult
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