Efficiency of brief interventions on alcohol-related risks in occupational medicine

Abstract

Aim. To evaluate the effectiveness of brief interventions (BIs) in reducing alcohol use among hazardous drinkers consulting their occupational doctors. Materials and methods. Design: Randomized controlled trial with 12-month follow-up, conducted between November 2004 and September 2006. Setting: Fifteen French regional occupational medicine centers with 147 doctors and 157 assistants who were trained in BI and screening with the AUDIT questionnaire. Participants: We invited 33,488 individuals to fill out AUDIT. These patients were eligible if their scores were 6–12 for women and 7–12 for men, indicating hazardous drinking without dependence (found in 7.1% of respondents). Intervention: After randomization, BIs (informative advice using motivational approach, with 10-minute average duration) were performed by the occupational doctors. The control group received information booklets from the doctors’ assistants. Measurements: Situations were evaluated 12 months after inclusion. Outcome measures: AUDIT scores, self-reported alcohol consumption (SRAC) and biological assays. The main criteria were the differences observed between groups for SRAC, the AUDIT score at follow-up, and any reduction in score between inclusion and final assessment. Success of intervention, which was defined as an AUDIT score below the hazardous drinking threshold at follow-up, was considered to analyze the variables associated with the efficiency of intervention. Results. The analyzed sample included 787 persons, among whom 435 were met again 12 months later. In the BI group, we found a lower AUDIT score ( p = 0.01), a higher reduction in reported consumptions (–60 g/week versus −44g/week, p = 0.04) and in AUDIT scores ( p = 0.009). In the control group, 44.8% reduced their AUDIT scores below hazardous drinking thresholds, as compared to 51.6% in the BI group ( p = 0.15). Success was associated with a significant reduction in biological and clinical indices. Conclusions. Though the high attrition rate led to careful conclusions, BIs seem to be efficient in occupational medicine, in comparison with written information, which also seems to influence drinking behavior.

Alcohol Screening and Brief Intervention in Workplace Settings and Social Services: A Comparison of Literature

“…Anderson et al ( 37 ) found a reduction of drinking days per week (from 2.39 to 1.95), and Osilla et al ( 41 ) reported a significant reduction of peak drinks per occasion from 7.56 to 4.78 in the intervention group that received ASBI within an employee assistance program (EAP). Significant reduction in the AUDIT score after 12 months (6.59 vs. 7.55; p = 0.01) were found by Michaud et al ( 36 ), but without showing significant effects in reducing hazardous drinking. The face-to-face plus website intervention of Doumas and Hannah ( 24 ) reduced the number of drinks per weekend from 2.42 to 1.87.…”

“…In this section, we provide an update of the results of our systematic review conducted in the framework for the EU project BISTAIRS 2 . Compared to the report published in 2012, the present study retrieved one additional article ( 36 ) in the workplace setting, resulting in 9 out of 3037 studies meeting our inclusion criteria (see Table 1 ). Key reasons for exclusion concerned, e.g., intervention characteristics (too long duration or general prevention), lack of effectiveness analyses, or inappropriate setting.…”

“…The methodological quality varied due to study design, measurements, inclusion criteria, and analysis. Quality appraisal based on the Cochrane collaboration’s risk-of-bias tool revealed that most studies failed to describe in detail the approach to selection [random sequence generation ( 24 , 36 – 40 ); allocation concealment ( 24 , 37 – 42 )] and performance biases [blinding of participants and personnel ( 24 , 36 – 39 , 41 , 42 )], resulting in the assessment of “unclear” in those areas. The random sequence generation of the study of Osilla et al ( 41 ) was rated to have a “high risk-of-bias,” the reporting of Michaud et al ( 36 ) was regarded as incomplete.…”

“…The majority of included studies were conducted in the USA ( 24 , 37 , 38 , 40 , 41 ), with a further three in Europe ( 27 , 36 , 42 ), with one in Japan ( 39 ). The company employment sector varied significantly, including organizations based in the transportation, food, and retail or manufacturing sectors.…”

La necesaria contribución de la ciencia a la prevención

“…Michaud (14) evaluó la eficiencia de las intervenciones breves en la reducción del consumo de alcohol en bebedores de riesgo que consultan a sus médicos de empresa. De 33.488 personas a las que se solicitó que contestaran al cuestionario AUDIT, los sujetos seleccionados fueron asignados aleatoriamente al grupo de intervención breve (IB) o al grupo de control.…”