360: Brief interventions may benefit heavy alcohol users admitted to hospital

August 30, 2012

PEARLS 360, October 2009, written by Brian R McAvoy

Clinical question : How effective are brief interventions in reducing alcohol consumption and improving outcomes for heavy alcohol users admitted to general hospital inpatient units? Heavy users were defined as those regularly consuming alcohol above the recommended safe weekly/daily amounts for the country in which the study took place.

Bottom line: Two studies indicated that alcohol consumption could be reduced at 1-year follow-up for people who received brief interventions as inpatients. A trend was observed towards consuming fewer grams of alcohol per week at 6 months in those receiving the brief intervention. No clear differences were observed between the brief intervention and control groups for self-report of alcohol consumption, laboratory markers (Gamma GT) or for the number of binges, driving offences or deaths.

Caveat: There was no consistency in baseline consumption levels for participant inclusion in the studies. The results of the studies were difficult to combine because of the different measures used to assess alcohol consumption and the substantial variation in how the studies were carried out. Screening alone may also have some impact on alcohol consumption levels.

Context: Brief interventions involve a time-limited intervention, focusing on changing behaviour. They range from a single session provid.ing information and advice, to 1 to 3 sessions of motivational interviewing or skills-based counselling, involving feedback and discussion about responsibility and self-efficacy. Different health professionals may provide the intervention. A Cochrane review has indicated benefits from brief interventions in primary care.1

Cochrane Systematic Review: McQueen J et al. Brief interventions for heavy alcohol users admit.ted to general hospital wards. Cochrane Reviews 2009, Issue 3. Article No. CD005191.DOI: 10.1002/14651858.CD005191.pub2. This review contains 11 studies involving 2441 participants.
Further reference 1. Kaner EFS et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Reviews 2008, Issue 1. Article No. CD004148 DOI: 10.1002/14651858.CD004148.pub3.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.