Kaner, Eileen, Bland, Martin, Cassidy, Paul, Coulton, Simon, Dale, Veronica, Deluca, Paolo, Gilvarry, Eilish, Godfrey, Christine, Heather, Nick, Myles, Judy, and others. (2013) Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): pragmatic cluster randomised controlled trial. British Medical Journal, 346 . ISSN 0959-8138. (doi:10.1136/bmj.e8501) (KAR id:33045)
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Official URL: http://dx.doi.org/10.1136/bmj.e8501 |
Abstract
Objective To evaluate the effectiveness of different brief intervention
strategies at reducing hazardous or harmful drinking in primary care.
The hypothesis was that more intensive intervention would result in a
greater reduction in hazardous or harmful drinking.
Design Pragmatic cluster randomised controlled trial.
Setting Primary care practices in the north east and south east of
England and in London.
Participants 3562 patients aged 18 or more routinely presenting in
primary care, of whom 2991 (84.0%) were eligible to enter the trial: 900
(30.1%) screened positive for hazardous or harmful drinking and 756
(84.0%) received a brief intervention. The sample was predominantly
male (62%) and white (92%), and 34% were current smokers.
Interventions Practices were randomised to three interventions, each
of which built on the previous one: a patient information leaflet control
group, five minutes of structured brief advice, and 20 minutes of brief
lifestyle counselling. Delivery of the patient leaflet and brief advice
occurred directly after screening and brief lifestyle counselling in a
subsequent consultation.
Main outcome measures The primary outcome was patients’ self
reported hazardous or harmful drinking status as measured by the alcohol
use disorders identification test (AUDIT) at six months. A negative AUDIT
result (score <8) indicated non-hazardous or non-harmful drinking.
Secondary outcomes were a negative AUDIT result at 12 months,
experience of alcohol related problems (alcohol problems questionnaire),
health utility (EQ-5D), service utilisation, and patients’ motivation to
change drinking behaviour (readiness to change) as measured by a
modified readiness ruler.
Results Patient follow-up rates were 83% at six months (n=644) and
79% at 12 months (n=617). At both time points an intention to treat
analysis found no significant differences in AUDIT negative status
between the three interventions. Compared with the patient information
leaflet group, the odds ratio of having a negative AUDIT result for brief
advice was 0.85 (95% confidence interval 0.52 to 1.39) and for brief
lifestyle counselling was 0.78 (0.48 to 1.25). A per protocol analysis
confirmed these findings.
Conclusions All patients received simple feedback on their screening
outcome. Beyond this input, however, evidence that brief advice or brief
lifestyle counselling provided important additional benefit in reducing
hazardous or harmful drinking compared with the patient information
leaflet was lacking.
Item Type: | Article |
---|---|
DOI/Identification number: | 10.1136/bmj.e8501 |
Projects: | Current Controlled Trials |
Subjects: |
H Social Sciences > HV Social pathology. Social and public welfare > HV5001 Alcoholism and intemperance R Medicine > RA Public aspects of medicine |
Divisions: | Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies |
Depositing User: | Tony Rees |
Date Deposited: | 21 Jan 2013 09:42 UTC |
Last Modified: | 16 Nov 2021 10:10 UTC |
Resource URI: | https://kar.kent.ac.uk/id/eprint/33045 (The current URI for this page, for reference purposes) |
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