Screening and Brief Alcohol Intervention in Routine Primary Care in the UK: SIPS Trial Outcomes at Six Months

Background: Over the past 25 years, many trials of screening and brief alcohol

intervention in primary care have reported positive effects in terms of reducing

excessive drinking. However, it is still not clear how applicable this evidence is to

routine primary care. In addition, there is a need to identify an efficient screening

strategy for busy medical practices. Lastly, the evidence-base in unclear on whether

brief structured advice or motivational counselling is the required form of brief

intervention to produce positive behaviour change. This SIPS trial is a pragmatic

evaluation based in regular primary care practices and involving general practitioners

and nurses who deliver screening and brief alcohol intervention during their day-to-day

work The aim of the trial is to evaluate the effectiveness and cost-effectiveness of

different models of screening to identify excessive drinkers and differing intensities of

brief intervention to reduce excessive drinking in routine practice.

Method: GPs and nurses from 24 practices in England were recruited. Practices were

randomly allocated to one of three brief intervention conditions: a leaflet-only control

group (n = 8); five minutes of brief structured advice (n = 8); and twenty minutes of brief

lifestyle counselling (n = 8). Practices were additionally randomised to either universal

or targeted screening and to use either a modified single item (M-SASQ) or the FAST

screening tool. Practices in each of the three intervention conditions were asked

to recruit at least 31 hazardous or harmful drinkers who received a short baseline

assessment followed by brief intervention. Patients were subsequently followed up at

six and twelve months after the intervention.

Results: Six month follow-up data will be completed by February 2010. With just one

month remaining, the follow-up rate is currently 86% and has included 560 patients.

The majority of the follow-up work has been via telephone although postal and email

follow-up have also been used.

Discussion: The presentation will report not only drinking outcomes following brief

intervention but also quality of life measures and health service use data. The findings

will answer the key question of whether brief intervention is effective in routine practice

and if structured advice is sufficient to change drinking behaviour in non-treatment

seeking patients or if motivational counselling is more impactful. Finally the costeffectiveness

of these approaches will be outlined.