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Effectiveness of physician-based interventions with problem drinkers: a review
1Department of Family and Community Medicine, University of Toronto, Ont.
Summary
Brief physician interventions effectively reduce alcohol consumption in men with drinking problems. While results for women are inconsistent and effects on morbidity are unclear, these interventions show significant public health potential.
Area of Science:
- Public Health
- Clinical Medicine
- Behavioral Science
Background:
- Problem drinking is a significant public health concern.
- Physician-led interventions are a potential strategy for addressing alcohol misuse.
Purpose of the Study:
- To systematically review randomized controlled trials (RCTs) evaluating the efficacy of brief physician interventions for problem drinkers.
Main Methods:
- Searched MEDLINE and EMBASE databases (1966/1972 onwards) using terms related to drinking and physician interventions.
- Included 11 RCTs of physician interventions in healthcare settings, excluding alcohol treatment clinics and non-physician interventions.
- Assessed trial validity and generalizability using a scoring system.
Main Results:
- Four high-validity trials indicated that men receiving brief physician interventions reduced weekly alcohol consumption by 5-7 standard drinks compared to controls.
- Intervention effects on alcohol consumption in women were inconsistent.
- No conclusive evidence demonstrated a reduction in alcohol-related morbidity for either sex.
Conclusions:
- Brief physician interventions are supported for patients with drinking problems.
- Further research is required to ascertain effects on morbidity/mortality and identify optimal patient selection, treatment intensity, and intervention components.
- The potential public health impact of these interventions is substantial.