BACKGROUND: The purpose of the present review was to evaluate the evidence of
the effectiveness of brief interventions aimed at reducing chronic alcohol use and
harm related to alcohol consumption, conducted among individuals actively attending
primary care but who were not seeking help for alcohol problems.
METHODS: Randomised trials reporting at-least one outcome related to alcohol
consumption and conducted in outpatients who were actively attending primary
care centre or provider were selected using Cochrane Central Register of Controlled
Trials, MEDLINE, PsycINFO, ISI Web of Science, ETOH database, and bibliographies
of the retrieved references and previous reviews. Selection and data abstraction
were performed independently and in duplicate. We assessed validity of the studies
and performed a meta-analysis for studies reporting alcohol consumption at 6 or
12 months follow up.
RESULTS: We included 24 reports, reporting results of 19 trials and including
5,639 individuals. Seventeen trials reported a measure of alcohol consumption, eight
reporting a significant effect of intervention. The meta-analysis showed a mean pooled
difference of -41 (95% CI: −54; −28) g of pure ethanol per week in favour of brief intervention
group. Evidences for other outcomes (laboratory values, health related quality
of life, morbidity and mortality, health care utilisation) were inconclusive.
CONCLUSION: Our systematic review indicated that brief intervention might be
effective for both men and women in reducing alcohol consumption compared to
a controlled intervention, in a primary health care population. The meta-analysis
confirmed the reduction in alcohol consumption at 6 and 12 month. Further
research should precise the components of effectiveness of brief intervention and
the evidence of effects on morbidity, mortality, and quality of life related outcomes.