Brief interventions for heavy alcohol users admitted to general hospital wards

McQueen, Jean; Howe, Tracey; Allan, Linda; Mains, Diane

doi:10.1002/14651858.cd005191.pub2

Cited by 98 publications

(119 citation statements)

References 62 publications

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“…It corroborates recent results from meta-analyses of cohort studies that reduction of drinking in people with alcohol problems [34,60] and reduction of drinking in people being treated for AD may result in significant mortality gains [61]. However, the latter study was unable to measure the association between the level of reduction of drinking and mortality as the underlying literature did not contain this information.…”

Section: Discussionsupporting

confidence: 82%

A Predictive Microsimulation Model to Estimate the Clinical Relevance of Reducing Alcohol Consumption in Alcohol Dependence

et al. 2014

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Background: Alcohol consumption is one of the most important factors for disease and disability in Europe. In clinical trials, nalmefene has resulted in a significant reduction in the number of heavy-drinking days (HDDs) per month and total alcohol consumption (TAC) among alcohol-dependent patients versus placebo. Methods: A microsimulation model was developed to estimate alcohol-attributable diseases and injuries in patients with alcohol dependence and to explore the clinical relevance of reducing alcohol consumption. Results: For all diseases and injuries considered, the number of events (inpatient episodes) increased with the number of HDDs and TAC per year. The model predicted that a reduction of 20 HDDs per year would result in 941 fewer alcohol-attributable events per 100,000 patients, while a reduction in intake of 3,000 g/year of pure alcohol (ethanol) would result in 1,325 fewer events per 100,000 patients. Conclusion: The potential gains of reducing consumption in alcohol-dependent patients were considerable.

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Section: Discussionsupporting

confidence: 82%

A Predictive Microsimulation Model to Estimate the Clinical Relevance of Reducing Alcohol Consumption in Alcohol Dependence

et al. 2014

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“…It is one of the most frequent psychiatric disorders and causes enormous societal costs [1,2,3,4,5]. Treatment options for AUD include self-help groups [6], support provided by general practitioners [7], and inpatient [8] and outpatient interventions [9] including rehabilitation [5,10,11]. Other interventions (e.g.…”

Section: Introductionmentioning

confidence: 99%

German Medical Students’ Beliefs about How Best to Treat Alcohol Use Disorder

et al. 2013

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Background/Aims: A minority of German medical students believe they know how to support smokers willing to quit. This paper examined whether the same would be true for treating alcohol use disorder (AUD), and individual factors associated with incorrect beliefs about the effectiveness of methods to treat AUD. Methods: In this cross-sectional study, 19,526 undergraduate students from 27 German medical schools completed a survey addressing beliefs about the effectiveness of different methods of overcoming AUD. Beliefs about AUD treatment effectiveness were compared across the 5 years of undergraduate education and predictors identified by means of multiple linear regression. Results: Even in the fifth year, 28.1% (95% CI: 26.5–29.7) of students believed that willpower alone was more effective for overcoming AUD than a comprehensive treatment program. The only significant predictor of this belief was a similar belief for stopping smoking. Conclusion: Our results indicate that a considerable proportion of German medical students overestimate the effectiveness of willpower to treat smoking and AUD. The addictive nature of these disorders needs to be stressed during undergraduate medical education to ensure that future physicians will be able and motivated to support patients in their quit attempts.

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“…Brief interventions are widely regarded as an effective strategy to reduce alcohol consumption in hazardous and harmful drinkers [1,2]. They are brief, and typically delivered by non-specialists in non-specialist settings.…”

Section: Introductionmentioning

confidence: 99%

“…in 2004 found the evidence to be inconclusive for brief interventions in a general hospital setting [5]. Contrastingly in 2011, McQueen et al ’s Cochrane meta-analysis of 14 trials on brief interventions in hospitals found that alcohol consumption was reduced at 6 and 9 months in the intervention group compared to the control group [2]. However unlike in a primary health care setting, this alcohol reduction was not maintained at 12-month follow-up.…”

Section: Introductionmentioning

confidence: 99%

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Randomised controlled trial of a brief alcohol intervention in a general hospital setting

Shiles

Canning

Kennell-Webb

et al. 2013

Trials

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BackgroundThe evidence suggests that brief alcohol-focused interventions, directed at hazardous and harmful drinkers in non-specialist settings such as primary care are effective in reducing alcohol consumption. However, there is a need for further research in the hospital setting. This is a randomised controlled trial to investigate the effectiveness of a 10-minute brief intervention amongst 'at risk’ drinkers admitted to general hospital wards. Unlike some previous trials, this trial is randomised, used blinded assessors, includes an intention-to-treat analysis, included female subjects and excluded people with alcohol dependence.MethodsA total of 250 'at risk’ drinkers admitted to King’s College Hospital were identified using the Alcohol Use Disorders Identification Test (AUDIT). Some 154 subjects entered the study and were randomly allocated to the control and intervention groups. Subjects in the control group received no advice about their drinking whilst subjects in the intervention group received 10 minutes of simple advice on reducing alcohol consumption. Recruitment took place between 1995 and 1997. The primary outcome was the AUDIT questionnaire at 12 months. Secondary outcomes were a previous week’s Drinks Diary, questionnaires (General Health Questionnaire, Alcohol Problems Questionnaire and the Severity of Alcohol Dependence Questionnaire) and laboratory blood tests (gamma glutamyl transferase, mean cell volume and haemoglobin).ResultsAt 3-month and 12-month follow-up, all participants were included in the intention-to-treat analysis. At both time points there was no evidence of an intervention effect that could be attributed to the brief intervention. Both the intervention and control groups had an improved AUDIT score and reduced levels of alcohol consumption as measured by a subjective Drinks Diary at 3 months which was maintained at 12 months.ConclusionsThis study has added further evidence on brief interventions in the hospital setting. In contrast to the recent Cochrane review by McQueen et al., the results of this study do not support the effectiveness of a brief alcohol intervention in general hospital wards. However our study was underpowered and there were flaws in the statistical analyses, and these limitations temper the strength of our conclusions.

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Brief interventions for heavy alcohol users admitted to general hospital wards

Cited by 98 publications

References 62 publications

A Predictive Microsimulation Model to Estimate the Clinical Relevance of Reducing Alcohol Consumption in Alcohol Dependence

A Predictive Microsimulation Model to Estimate the Clinical Relevance of Reducing Alcohol Consumption in Alcohol Dependence

German Medical Students’ Beliefs about How Best to Treat Alcohol Use Disorder

Randomised controlled trial of a brief alcohol intervention in a general hospital setting

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