This paper was supported by National Institute of Alcohol Abuse and Alcoholism Grant 1R01-AA-12826 and by the Department of Family Medicine of the University of Wisconsin School of Medicine and Public Health. Pilot study work was supported by the American Academy of Family Physicians Foundation.
Randomized-Controlled Trial of a Telephone and Mail Intervention for Alcohol Use Disorders: Three-Month Drinking Outcomes
Article first published online: 5 JUN 2007
Alcoholism: Clinical and Experimental Research
Volume 31, Issue 8, pages 1372–1379, August 2007
How to Cite
Brown, R. L., Saunders, L. A., Bobula, J. A., Mundt, M. P. and Koch, P. E. (2007), Randomized-Controlled Trial of a Telephone and Mail Intervention for Alcohol Use Disorders: Three-Month Drinking Outcomes. Alcoholism: Clinical and Experimental Research, 31: 1372–1379. doi: 10.1111/j.1530-0277.2007.00430.x
- Issue published online: 5 JUN 2007
- Article first published online: 5 JUN 2007
- Received for publication March 9, 2006; accepted April 11, 2007.
- Alcohol Use Disorders;
- Motivational Interviewing;
- Primary Care;
- Sex Factors
Background: Alcohol screening, brief intervention, and referral to specialized treatment (ASBIR) reduce drinking and related harms. Unanswered questions are how to manage nondependent patients with poor response to brief interventions, how to manage dependent patients who do not obtain treatment, and how to ensure population-wide delivery of ASBIR. Telephone-administered counseling may provide answers.
Methods: We conducted a 12-month randomized controlled trial of a telephone and mail intervention for non-treatment–seeking primary care patients with alcohol use disorders. We enrolled 897 subjects after systematic screening in 18 primary care clinic waiting rooms in and around Madison and Milwaukee, Wisconsin, and subsequent telephone-administered diagnostic interviews. Experimental subjects received up to six sessions of protocol-driven telephone counseling based on principles of motivational interviewing and stages of readiness to change. Control subjects received a pamphlet on healthy lifestyles. The paper reports on 3-month drinking outcomes for men and women with alcohol abuse and dependence.
Results: Male experimental subjects (N=199) manifested a 30.6% decline in risky drinking days, compared with a 8.3% decline in controls (N=201, p<0.001). The total consumption declined by 17.3% compared with 12.9% by controls (p=0.001). Female experimental subjects (N=246) manifested a 17.2% decrease in risky drinking days compared with an 11.5% decrease by controls (N=251; p=NS) and a 13.9% decline in total consumption compared with 11.0% by controls (p=NS). Greater numbers of telephone counseling sessions were associated with greater declines in drinking.
Conclusion: Following systematic screening, a six-session telephone and mail intervention is more effective than a pamphlet in reducing drinking at 3 months for non-treatment–seeking men with alcohol abuse and dependence. An intervention effect of the enrollment procedures may have obscured further intervention effectiveness. Telephone counseling shows promise for non-treatment–seeking primary care patients with alcohol use disorders.