Prioritization of outcomes in efficacy and effectiveness of alcohol brief intervention trials: International Multi-stakeholder e-Delphi Consensus Study to inform a core outcome set

Objective: Outcomes used in alcohol brief intervention (ABI) trials vary considerably. Achieving consensus about key outcomes can enhance evidence synthesis and improve healthcare guidelines. This was an international, e-Delphi study to prioritize outcomes for ABI trials as one step in a larger effort to develop an ABI core outcome set (COS).
Method: 150 registrants from 19 countries, and representing researchers, policymakers, and patients, participated in a two-round e-Delphi study. In Round 1, participants (n=137) rated 86 outcomes, derived from a review of the literature and a patient and public involvement panel, by importance. In Round 2, participants (n=114) received feedback on importance ratings for each outcome and a reminder of their personal rating before rating the outcomes for importance a second time. Seven additional outcomes suggested in Round 1 were added to the Round 2 questionnaire. We defined consensus a priori as 70% agreement across all stakeholder groups.
Results: Seven consumption outcomes met inclusion criteria: typical frequency, typical quantity, frequency of heavy drinking, alcohol-related problems, and weekly drinks, at risk drinking, and combined consumption measures. Others meeting the threshold were: alcohol-related injury; quality of life; readiness to change; and intervention fidelity.
Conclusions: This is the first international e-Delphi study to identify and prioritize outcomes for use in ABI trials. The use and reporting of outcomes in future ABI trials should improve evidence synthesis in systematic reviews and meta-analyses. Further work is required to refine these outcomes into a COS that includes guidance for measurement of outcomes.