PEARLS 13, September 2007, written by Brian R McAvoy

Clinical question
Are brief alcohol interventions (BAIs) effective in reducing alcohol consumption in primary care populations?

Bottom line
BAIs consistently produced reductions in alcohol consumption. At one year's follow-up, people who had received BAIs drank 6-25g less alcohol per week. The benefit for men (70 per cent of participants) was a reduction of 57g per week (range 25-89g). The benefit was not clear for women. The reduction in drinking was similar in general practice and accident and emergency department settings to research settings with greater resources. Longer counselling showed little additional benefit.

Caveat
BAIs are aimed at individuals drinking at hazardous or harmful levels, ie, whose consumption exceeds recommended drinking levels (<21 standard drinks/week for men and <14 standard drinks/week for women in New Zealand), but not at those who are dependent on alcohol.

Context
BAIs include feedback on alcohol use and harms, identification of high-risk situations
for drinking and coping strategies, increased motivation and the development of a personal plan to reduce drinking. They involve one to four sessions, and take place within the timeframe of a standard consultation, 5 to 10 minutes for a GP, longer for a nurse.

Cochrane Systematic Review
Kaner EFS et. al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database of Systematic Reviews 2007, Issue 2. Article No. CD004148. DOI: 10.1002/14651858.CD004148.pub3. Note: This review contains 28 studies with over 7000 participants.