Brief Counseling at Regular Office Visits Reduces Drinking for 1 Year
In most studies of alcohol brief interventions, counseling occurs during a visit scheduled specifically to discuss unhealthy alcohol use rather than during a routine primary care visit. However, some research has found that 5-10 minutes of counseling during a regularly scheduled primary care visit can decrease weekly consumption at the 6-month follow-up. To examine whether this decrease remains at 12 months, researchers analyzed data from 445 adult patients who had been drinking risky amounts* and had participated in a controlled trial of brief intervention during regular primary care visits. Of the 46 participating clinicians (from 4 different primary care practices), 19 had received training in and provided brief intervention.
In analyses adjusted for potential confounders (e.g., sex, baseline level of consumption), patients assigned to brief intervention, compared with those assigned to usual care,
significantly greater decreases in the average number of drinks
consumed per week
(-5.7 versus -3.2 drinks);
- had significantly fewer episodes of binge drinking** per month (-2.0 versus -1.6 episodes);
- were more likely to adhere to safe drinking limits at the 12-month follow-up (54% versus 49%, a borderline significant finding).
This study demonstrates that a single, 5-10 minute brief intervention during a regular primary care visit can produce modest, yet lasting, reductions in alcohol intake among patients drinking risky amounts. Additional research is needed to determine whether brief counseling over multiple visits in the context of a long-term patient-clinician relationship can further reduce risky drinking.Peter D. Friedmann, MD, MPH
**>=5 drinks on 1 occasion for men; >=4 drinks on 1 occasion for women
Reiff-Hekking S, Ockene JK, Hurley TG, et al. Brief physician and nurse practitioner-delivered counseling for high-risk drinking. Results at 12-month follow-up. J Gen Intern Med. 2005;20(1):7–13.