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[One-year assessment of the brief intervention program carried out by general practitioners in patients with alcohol
Jean-Claude Casset1, Pascal Bérenger, Jean-Luc Bosson
1Réseau départemental d'ALcoologie de la Savoie (RéALS), 73000 Chambéry, France. jc.casset@cegetel.net
Goals:
As part of the integration process of the long-term, large-scale RPIB program ("repérage précoce et intervention brève" or early screening and brief intervention program) conducted in general practice in the French department of Savoie, we believed it was essential to provide general practitioners planning to initiate the RPIB program with an assessment of the work carried out by their local colleagues. For 6months, 29 attending general practitioners from Savoie, France, screened 5,552 patients on a random basis regarding their alcohol consumption. They performed one or more brief interventions in most of the patients misusing alcohol. The impact at one year was analysed in these patients.
Methodology:
The tools used were declared consumption of alcohol (DCA) and the FACE questionnaire, which allowed classifying the patients on the basis of their use of alcohol (French Society of Alcohology): use (consumption below the WHO threshold), misuse (risky use), harmful use, alcohol dependence. The patients displaying misuse were subject to a brief intervention (set up in France by the ANPAA-BMCM team*), as recommended by WHO. One year later, the physicians re-evaluated the DCA and FACE score in these patients. The analysis consisted in comparing the progress of the DCA and checking whether the patients initially displaying misuse could now be classified among the use group.
Results:
The following significant changes were observed (Student's test, Chi2, logistic regression): the DCA decreased on average from 20 to 14.9 glasses per week; 32,5% of the 400patients misusing alcohol were classified in the use group; 38,2% of patients lowered their consumption by at least 30%; women with a FACE score of 4 had a mean consumption of 7 glasses per week (a figure well under the WHO threshold) and the percentage of women over this threshold was low (6%).
Conclusion:
These results agree with those of the international publications. The french FACE tool seems to require slight modification (brief intervention should not be considered in women with a score of 4: in most cases, they do not seem to have an alcohol misuse issue).
