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,

• had
  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).

Comments:

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

Reference:

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.