PEARLS No. 205, October 2009, written by Brian R McAvoy - download pdf

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 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 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 providing information and advice, to 1 to 3 sessions of motivational interviewing or skills-based counselling, involving feedback and discussion on responsibility and self-efficacy. Different health professionals may give 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 admitted 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.