Brief Physician and Nurse Practitioner–delivered Counseling for High-risk Drinking

Results at 12-Month Follow-up

Authors


  • The authors certify that all financial and material support for this research and work are clearly identified in the manuscript. They have not been engaged in any financial or personal conflicts of interests as a result of the research described in this manuscript. The authors had full access to all of the study data and accept full responsibility for the integrity of the data and the accuracy of the data analysis. As noted in the acknowledgments, the research described in this manuscript was supported by a grant from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institutes of Health, Bethesda, MD. NIAAA was not involved in study design, collection, analysis, or interpretation of these data.

Address correspondence and requests for reprints to Dr. Reiff-Hekking: Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 (e-mail: Sarah.Reiff@Umassmed.edu).

Abstract

Background: The objective of this study was to determine the effects of a brief primary care provider–delivered counseling intervention on the reduction of alcohol consumption by high-risk drinkers. The intervention was implemented as part of routine primary care medical practice.

Methods: We performed a controlled clinical trial with 6- and 12-month follow-up. Three primary care practices affiliated with an academic medical center were randomly assigned to special intervention (SI) or usual care (UC). A total of 9,772 primary care patients were screened for high-risk drinking. A fourth site was added later. From the group that was screened, 530 high-risk drinkers entered into the study, with 447 providing follow-up at 12 months. The intervention consisted of brief (5–10 minute) patient-centered counseling plus an office system that cued providers to intervene and provided patient educational materials.

Results: At 12-month follow-up, after controlling for baseline differences in alcohol consumption, SI participants had significantly larger changes (P=.03) in weekly alcohol intake compared to UC (SI=−5.7 drinks per week; UC=−3.1 drinks per week), and of those who changed to safe drinking at 6 months more SI participants maintained that change at 12 months than UC.

Conclusions: Project Health provides evidence that screening and very brief (5–10 minute) advice and counseling delivered by a patient's personal physician or nurse practitioner as a routine part of a primary care visit can reduce alcohol consumption by high-risk drinkers.

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