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Review
. 2014 Sep 1:5:114.
doi: 10.3389/fpsyt.2014.00114. eCollection 2014.

What are the Implications for Policy Makers? A Systematic Review of the Cost-Effectiveness of Screening and Brief Interventions for Alcohol Misuse in Primary Care

Colin Angus  1 , Nicholas Latimer  1 , Louise Preston  1 , Jessica Li  1 , Robin Purshouse  2
Affiliations
Review

What are the Implications for Policy Makers? A Systematic Review of the Cost-Effectiveness of Screening and Brief Interventions for Alcohol Misuse in Primary Care

Colin Angus et al. Front Psychiatry. .

Abstract

Introduction: The efficacy of screening and brief interventions (SBIs) for excessive alcohol use in primary care is well established; however, evidence on their cost-effectiveness is limited. A small number of previous reviews have concluded that SBI programs are likely to be cost-effective but these results are equivocal and important questions around the cost-effectiveness implications of key policy decisions such as staffing choices for delivery of SBIs and the intervention duration remain unanswered.

Methods: Studies reporting both the costs and a measure of health outcomes of programs combining SBIs in primary care were identified by searching MEDLINE, EMBASE, Econlit, the Cochrane Library Database (including NHS EED), CINAHL, PsycINFO, Assia and the Social Science Citation Index, and Science Citation Index via Web of Knowledge. Included studies have been stratified both by delivery staff and intervention duration and assessed for quality using the Drummond checklist for economic evaluations.

Results: The search yielded a total of 23 papers reporting the results of 22 distinct studies. There was significant heterogeneity in methods and outcome measures between studies; however, almost all studies reported SBI programs to be cost-effective. There was no clear evidence that either the duration of the intervention or the delivery staff used had a substantial impact on this result.

Conclusion: This review provides strong evidence that SBI programs in primary care are a cost-effective option for tackling alcohol misuse.

Keywords: alcohol drinking; brief alcohol intervention; brief intervention; policy making; primary care; resource allocation; screening and brief intervention; systematic review.

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Figures

Figure 1
Figure 1
Search strategy utilized in the review.
Figure 2
Figure 2
Cost-effectiveness of SBI programs by SBI duration and delivery staff.
See this image and copyright information in PMC

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