Screening and brief alcohol intervention in routine primary care in the UK: 12-month outcomes

Eileen Kaner, Colin Drummond, Paolo Deluca, Dorothy Newbury-birch, Simon Coulton

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Abstract

Numerous brief intervention (BI) trials have reported positive effects in primary care. However, it is unclear if structured advice or counseling is the more effective form of BI. The Screening and Intervention Program for Sensible Drinking (SIPS) trial aimed to evaluate the cost-effectiveness of different intensities of BI at reducing risky drinking in primary care. Practices were randomly allocated to one of three conditions: a leaflet-only control; five minutes of brief structured advice; or 20 minutes of brief counseling. Practices were asked to recruit at least 31 risk drinkers who received a short assessment followed by BI. Patients were followed up at six and 12 months post-intervention. The primary outcome was the proportion of risky drinkers as measured by the Alcohol Use Disorders Identification Test (AUDIT). Overall, 3562 patients were assessed for eligibility in 29 practices: 2991 (84%) were eligible; 900 (30%) screened positive for risky drinking; and 752 (83.6%) consented to participate in the trial. At 12 months, 79% patients (n = 598) were available for follow-up. No significant differences in follow-up rates were observed by condition. There was an overall reduction in risky drinking of 16.5% between baseline and 12 months. By condition, the reductions were 17.3% for controls, 12.7% for brief advice, and 19.6% for brief counseling. An adjusted logistic regression model identified baseline AUDIT score and gender as significant predictors of risky drinking at 12 months. Patients with lower baseline scores and women were more likely to be negative for risky drinking at follow-up based on AUDIT score. Brief advice and brief counseling did not produce significantly greater effects in reducing risky drinking than leaflet-only. We discuss these findings in light of the current BI literature.
Original languageEnglish
Article numberA81
JournalAddiction science & clinical practice
Volume7
Issue numberSuppl 1
DOIs
Publication statusPublished - 1 Jan 2012

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Drinking
Primary Health Care
Alcohols
Counseling
Logistic Models
Cost-Benefit Analysis
Identification (Psychology)

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title = "Screening and brief alcohol intervention in routine primary care in the UK: 12-month outcomes",
abstract = "Numerous brief intervention (BI) trials have reported positive effects in primary care. However, it is unclear if structured advice or counseling is the more effective form of BI. The Screening and Intervention Program for Sensible Drinking (SIPS) trial aimed to evaluate the cost-effectiveness of different intensities of BI at reducing risky drinking in primary care. Practices were randomly allocated to one of three conditions: a leaflet-only control; five minutes of brief structured advice; or 20 minutes of brief counseling. Practices were asked to recruit at least 31 risk drinkers who received a short assessment followed by BI. Patients were followed up at six and 12 months post-intervention. The primary outcome was the proportion of risky drinkers as measured by the Alcohol Use Disorders Identification Test (AUDIT). Overall, 3562 patients were assessed for eligibility in 29 practices: 2991 (84{\%}) were eligible; 900 (30{\%}) screened positive for risky drinking; and 752 (83.6{\%}) consented to participate in the trial. At 12 months, 79{\%} patients (n = 598) were available for follow-up. No significant differences in follow-up rates were observed by condition. There was an overall reduction in risky drinking of 16.5{\%} between baseline and 12 months. By condition, the reductions were 17.3{\%} for controls, 12.7{\%} for brief advice, and 19.6{\%} for brief counseling. An adjusted logistic regression model identified baseline AUDIT score and gender as significant predictors of risky drinking at 12 months. Patients with lower baseline scores and women were more likely to be negative for risky drinking at follow-up based on AUDIT score. Brief advice and brief counseling did not produce significantly greater effects in reducing risky drinking than leaflet-only. We discuss these findings in light of the current BI literature.",
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Screening and brief alcohol intervention in routine primary care in the UK: 12-month outcomes. / Kaner, Eileen; Drummond, Colin; Deluca, Paolo; Newbury-birch, Dorothy; Coulton, Simon.

In: Addiction science & clinical practice, Vol. 7, No. Suppl 1, A81, 01.01.2012.

Research output: Contribution to journalMeeting AbstractResearchpeer-review

TY - JOUR

T1 - Screening and brief alcohol intervention in routine primary care in the UK: 12-month outcomes

AU - Kaner, Eileen

AU - Drummond, Colin

AU - Deluca, Paolo

AU - Newbury-birch, Dorothy

AU - Coulton, Simon

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Numerous brief intervention (BI) trials have reported positive effects in primary care. However, it is unclear if structured advice or counseling is the more effective form of BI. The Screening and Intervention Program for Sensible Drinking (SIPS) trial aimed to evaluate the cost-effectiveness of different intensities of BI at reducing risky drinking in primary care. Practices were randomly allocated to one of three conditions: a leaflet-only control; five minutes of brief structured advice; or 20 minutes of brief counseling. Practices were asked to recruit at least 31 risk drinkers who received a short assessment followed by BI. Patients were followed up at six and 12 months post-intervention. The primary outcome was the proportion of risky drinkers as measured by the Alcohol Use Disorders Identification Test (AUDIT). Overall, 3562 patients were assessed for eligibility in 29 practices: 2991 (84%) were eligible; 900 (30%) screened positive for risky drinking; and 752 (83.6%) consented to participate in the trial. At 12 months, 79% patients (n = 598) were available for follow-up. No significant differences in follow-up rates were observed by condition. There was an overall reduction in risky drinking of 16.5% between baseline and 12 months. By condition, the reductions were 17.3% for controls, 12.7% for brief advice, and 19.6% for brief counseling. An adjusted logistic regression model identified baseline AUDIT score and gender as significant predictors of risky drinking at 12 months. Patients with lower baseline scores and women were more likely to be negative for risky drinking at follow-up based on AUDIT score. Brief advice and brief counseling did not produce significantly greater effects in reducing risky drinking than leaflet-only. We discuss these findings in light of the current BI literature.

AB - Numerous brief intervention (BI) trials have reported positive effects in primary care. However, it is unclear if structured advice or counseling is the more effective form of BI. The Screening and Intervention Program for Sensible Drinking (SIPS) trial aimed to evaluate the cost-effectiveness of different intensities of BI at reducing risky drinking in primary care. Practices were randomly allocated to one of three conditions: a leaflet-only control; five minutes of brief structured advice; or 20 minutes of brief counseling. Practices were asked to recruit at least 31 risk drinkers who received a short assessment followed by BI. Patients were followed up at six and 12 months post-intervention. The primary outcome was the proportion of risky drinkers as measured by the Alcohol Use Disorders Identification Test (AUDIT). Overall, 3562 patients were assessed for eligibility in 29 practices: 2991 (84%) were eligible; 900 (30%) screened positive for risky drinking; and 752 (83.6%) consented to participate in the trial. At 12 months, 79% patients (n = 598) were available for follow-up. No significant differences in follow-up rates were observed by condition. There was an overall reduction in risky drinking of 16.5% between baseline and 12 months. By condition, the reductions were 17.3% for controls, 12.7% for brief advice, and 19.6% for brief counseling. An adjusted logistic regression model identified baseline AUDIT score and gender as significant predictors of risky drinking at 12 months. Patients with lower baseline scores and women were more likely to be negative for risky drinking at follow-up based on AUDIT score. Brief advice and brief counseling did not produce significantly greater effects in reducing risky drinking than leaflet-only. We discuss these findings in light of the current BI literature.

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DO - 10.1186/1940-0640-7-S1-A81

M3 - Meeting Abstract

VL - 7

JO - Addiction science & clinical practice

JF - Addiction science & clinical practice

SN - 1940-0632

IS - Suppl 1

M1 - A81

ER -