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Article Abstract
Objective: To evaluate the effectiveness of a doctor delivered screening and ultra-brief intervention (<1 minute) compared with simplified assessment only for reducing alcohol intake among patients with hazardous drinking in primary care.
Design: Pragmatic cluster randomised controlled trial.
Setting: 40 primary care clinics in Japan that did not provide routine screening and brief intervention for hazardous drinking or treatment or self-help groups for alcohol dependency.
Participants: 1133 outpatients aged 20-74 years with hazardous drinking (AUDIT-C (alcohol use disorders identification test-consumption) scores ≥5 for men and ≥4 for women). Clinic clusters were allocated to a study arm using a computer generated random sequence. Participants and staff who collected participant reported outcomes remained blinded to assignment.
Interventions: Primary care clinics were randomised to ultra-brief intervention (21 clinics, 531 patients) or simplified assessment only (19 clinics, 602 patients) groups. The intervention group comprised screening with AUDIT-C followed by brief oral advice and an alcohol information leaflet delivered in <1 minute. The control group comprised simplified assessment with AUDIT-C only.
Main Outcome Measures: The primary outcome was total alcohol consumption in the four weeks preceding the 24 week follow-up. Secondary outcomes included total alcohol consumption in the four weeks preceding the 12 week follow-up, and readiness to change drinking behaviour, measured at 12 and 24 weeks.
Results: At 24 weeks, the difference in total alcohol consumption between the ultra-brief intervention group (1046.9 g/4 weeks (g/4wk), 95% confidence interval (CI) 918.3 to 1175.4) and control group (1019.0 g/4wk, 893.5 to 1144.6) was 27.8 g/4wk (-149.7 to 205.4, P=0.75), with a Hedges' g of 0.02 (95% CI -0.10 to 0.14). At 12 weeks, the difference in total alcohol consumption between the intervention group (1034.1 g/4wk, 919.6 to 1148.7) and control group (979.3 g/4wk, 866.1 to 1092.4) was 54.9 g/4wk (-104.1 to 213.9, P=0.49), with a Hedges' g of 0.04 (-0.08 to 0.16).
Conclusion: This trial found no evidence to support the effectiveness of a doctor delivered ultra-brief intervention for hazardous drinking compared with simplified assessment only in primary care in Japan.
Trial Registration: UMIN Clinical Trials Registry UMIN000051388.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340667 | PMC |
| http://dx.doi.org/10.1136/bmj-2024-083985 | DOI Listing |
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