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Meta-Analysis
. 2018 Feb 24;2(2):CD004148.
doi: 10.1002/14651858.CD004148.pub4.

Effectiveness of brief alcohol interventions in primary care populations

Eileen Fs Kaner  1 , Fiona R Beyer, Colin Muirhead, Fiona Campbell, Elizabeth D Pienaar, Nicolas Bertholet, Jean B Daeppen, John B Saunders, Bernard Burnand
Affiliations
Meta-Analysis

Effectiveness of brief alcohol interventions in primary care populations

Eileen Fs Kaner et al. Cochrane Database Syst Rev. .

Abstract

Background: Excessive drinking is a significant cause of mortality, morbidity and social problems in many countries. Brief interventions aim to reduce alcohol consumption and related harm in hazardous and harmful drinkers who are not actively seeking help for alcohol problems. Interventions usually take the form of a conversation with a primary care provider and may include feedback on the person's alcohol use, information about potential harms and benefits of reducing intake, and advice on how to reduce consumption. Discussion informs the development of a personal plan to help reduce consumption. Brief interventions can also include behaviour change or motivationally-focused counselling.This is an update of a Cochrane Review published in 2007.

Objectives: To assess the effectiveness of screening and brief alcohol intervention to reduce excessive alcohol consumption in hazardous or harmful drinkers in general practice or emergency care settings.

Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and 12 other bibliographic databases to September 2017. We searched Alcohol and Alcohol Problems Science Database (to December 2003, after which the database was discontinued), trials registries, and websites. We carried out handsearching and checked reference lists of included studies and relevant reviews.

Selection criteria: We included randomised controlled trials (RCTs) of brief interventions to reduce hazardous or harmful alcohol consumption in people attending general practice, emergency care or other primary care settings for reasons other than alcohol treatment. The comparison group was no or minimal intervention, where a measure of alcohol consumption was reported. 'Brief intervention' was defined as a conversation comprising five or fewer sessions of brief advice or brief lifestyle counselling and a total duration of less than 60 minutes. Any more was considered an extended intervention. Digital interventions were not included in this review.

Data collection and analysis: We used standard methodological procedures expected by Cochrane. We carried out subgroup analyses where possible to investigate the impact of factors such as gender, age, setting (general practice versus emergency care), treatment exposure and baseline consumption.

Main results: We included 69 studies that randomised a total of 33,642 participants. Of these, 42 studies were added for this update (24,057 participants). Most interventions were delivered in general practice (38 studies, 55%) or emergency care (27 studies, 39%) settings. Most studies (61 studies, 88%) compared brief intervention to minimal or no intervention. Extended interventions were compared with brief (4 studies, 6%), minimal or no intervention (7 studies, 10%). Few studies targeted particular age groups: adolescents or young adults (6 studies, 9%) and older adults (4 studies, 6%). Mean baseline alcohol consumption was 244 g/week (30.5 standard UK units) among the studies that reported these data. Main sources of bias were attrition and lack of provider or participant blinding. The primary meta-analysis included 34 studies (15,197 participants) and provided moderate-quality evidence that participants who received brief intervention consumed less alcohol than minimal or no intervention participants after one year (mean difference (MD) -20 g/week, 95% confidence interval (CI) -28 to -12). There was substantial heterogeneity among studies (I² = 73%). A subgroup analysis by gender demonstrated that both men and women reduced alcohol consumption after receiving a brief intervention.We found moderate-quality evidence that brief alcohol interventions have little impact on frequency of binges per week (MD -0.08, 95% CI -0.14 to -0.02; 15 studies, 6946 participants); drinking days per week (MD -0.13, 95% CI -0.23 to -0.04; 11 studies, 5469 participants); or drinking intensity (-0.2 g/drinking day, 95% CI -3.1 to 2.7; 10 studies, 3128 participants).We found moderate-quality evidence of little difference in quantity of alcohol consumed when extended and no or minimal interventions were compared (-14 g/week, 95% CI -37 to 9; 6 studies, 1296 participants). There was little difference in binges per week (-0.08, 95% CI -0.28 to 0.12; 2 studies, 456 participants; moderate-quality evidence) or difference in days drinking per week (-0.45, 95% CI -0.81 to -0.09; 2 studies, 319 participants; moderate-quality evidence). Extended versus no or minimal intervention provided little impact on drinking intensity (9 g/drinking day, 95% CI -26 to 9; 1 study, 158 participants; low-quality evidence).Extended intervention had no greater impact than brief intervention on alcohol consumption, although findings were imprecise (MD 2 g/week, 95% CI -42 to 45; 3 studies, 552 participants; low-quality evidence). Numbers of binges were not reported for this comparison, but one trial suggested a possible drop in days drinking per week (-0.5, 95% CI -1.2 to 0.2; 147 participants; low-quality evidence). Results from this trial also suggested very little impact on drinking intensity (-1.7 g/drinking day, 95% CI -18.9 to 15.5; 147 participants; very low-quality evidence).Only five studies reported adverse effects (very low-quality evidence). No participants experienced any adverse effects in two studies; one study reported that the intervention increased binge drinking for women and two studies reported adverse events related to driving outcomes but concluded they were equivalent in both study arms.Sources of funding were reported by 67 studies (87%). With two exceptions, studies were funded by government institutes, research bodies or charitable foundations. One study was partly funded by a pharmaceutical company and a brewers association, another by a company developing diagnostic testing equipment.

Authors' conclusions: We found moderate-quality evidence that brief interventions can reduce alcohol consumption in hazardous and harmful drinkers compared to minimal or no intervention. Longer counselling duration probably has little additional effect. Future studies should focus on identifying the components of interventions which are most closely associated with effectiveness.

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Conflict of interest statement

Nicolas Bertholet is salaried by Lausanne University Hospital, a public institution; he has received grants from the Swiss National Science Foundation, the Swiss Foundation for Alcohol Research, and the Department of Community Medicine and Health from the Lausanne University Hospital. He has received no personal support from industry sources such as pharmaceutical, alcohol and tobacco companies and holds no personal stock. Dr Bertholet is an author of a previous systematic review on the subject (Bertholet 2005), and has participated in numerous studies on screening and brief intervention (not limited to the scope of this review), including as a primary investigator of a randomised trial of an electronic screening and brief intervention.

Bernard Burnand, MD, MPH, is Chief Physician at the Institute of Social and Preventive medicine, Lausanne University Hospital. He is salaried full time by the this public institution (Canton of Vaud, Switzerland) and a full professor at the Faculty of Biology and Medicine, University of Lausanne. Bernard Burnand is also Director of Cochrane Switzerland (Cochrane associated centre). His research is supported by Lausanne University Hospital and funding from public granting institutions. ORCID ID: orcid.org/0000‐0002‐5678‐6044

Fiona Campbell has no conflicts of interest to declare.

Jean‐Bernard Daeppen received personal fees from Lundbeck SAS for lectures and advice and was involved in the Daeppen 2007 trial, which is an included trial in this systematic review.

Elizabeth Pienaar is in the full‐time employ of the South African Medical Research Council and has no conflicts of interest to declare.

John B Saunders has no conflicts of interest to declare.

Eileen Kaner, Fiona Beyer and Colin Muirhead are authors on a related Cochrane Review on interventions for reducing hazardous and harmful alcohol consumption (Kaner 2017).

Eileen Kaner is an investigator on the ongoing SIPS Junior trial (NIHR programme grant number NIHR RP‐PG‐0609‐10162). She was also involved in the SIPS trial (Kaner 2013) and the Lock 2006 trial which are included studies in this systematic review.

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
4
4
Funnel plot for quantity of drinking at 12 months, with pseudo 95% confidence limits.
5
5
Meta‐regression of quantity of drinking at 12 months on year of publication of trial.
6
6
Funnel plot for quantity of drinking at 12 months, adjusted for year of publication, with pseudo 95% confidence limits.
7
7
Meta‐regression of quantity of drinking at 12 months on baseline consumption.
8
8
Meta‐regression of quantity of drinking at 12 months on treatment exposure (mean duration of intervention for the participants in the trial), for trials comparing brief intervention with control.
9
9
Meta‐regression of quantity of drinking at 12 months on effectiveness/efficacy score of trial. Lower scores indicate greater efficacy.
10
10
Meta‐regression of quantity of drinking at 12 months on treatment exposure (mean duration of counselling for the participants in the trial), for trials comparing brief or extended intervention with control.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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Moore 2011 {published data only}
    1. Borok J, Galier P, Dinolfo M, Welgreen S, Hoffing M, Davis JW, et al. Why do older unhealthy drinkers decide to make changes or not in their alcohol consumption? Data from the Healthy Living as You Age study. Journal of the American Geriatrics Society 2013;61(8):1296‐1302. - PMC - PubMed
    1. Lin JC, Karno MP, Barry KL, Blow FC, Davis JW, Tang L, et al. Determinants of early reductions in drinking in older at‐risk drinkers participating in the intervention arm of a trial to reduce at‐risk drinking in primary care. Journal of the American Geriatric Society 2010;58(2):227‐33. - PMC - PubMed
    1. Lin JC, Karno MP, Tang L, Barry KL, Blow FC, Davis JW, et al. Do health educator telephone calls reduce at‐risk drinking among older adults in primary care?. Journal of General Internal Medicine 2010;25(4):334‐9. - PMC - PubMed
    1. Moore AA, Blow FC, Hoffing M, Welgreen S, Davis J, Lin JC, et al. Primary care‐based intervention to reduce at‐risk drinking in older adults: a randomized controlled trial. Addiction (Abingdon, England) 2010;106(1):111‐20. - PMC - PubMed
Noknoy 2010 {published data only}
    1. Noknoy S, Rangsin R, Saengcharnchai P, Tantibhaedhyangkul U, McCambridge J. RCT of effectiveness of motivational enhancement therapy delivered by nurses for hazardous drinkers in primary care units in Thailand. Alcohol and Alcoholism (Oxford, Oxfordshire) 2010;45(3):263‐70. - PMC - PubMed
Ockene 1999 {published data only}
    1. Ockene JK, Adams A, Hurley TG, Wheeler EV, Hebert JR. Brief physician‐ and nurse practitioner‐delivered counseling for high‐risk drinkers: does it work?. Archives of Internal Medicine 1999;159(18):2198‐205. - PubMed
    1. Ockene JK, Reed GW, Reiff‐Hekking S. Brief patient‐centered clinician‐delivered counseling for high‐risk drinking: 4‐year results. Annals of Behavioral Medicine 2009;37(3):335‐42. - PubMed
    1. Reiff‐Hekking S, Ockene JK, Hurley TG, Reed GW. Brief physician and nurse practitioner‐delivered counseling for high‐risk drinking. Results at 12 months follow‐up. Journal of General Internal Medicine 2005;20(1):7‐13. - PMC - PubMed
Richmond 1995 {published data only}
    1. Richmond R, Heather N, Wodak A, Kehoe L, Webster I. Controlled evaluation of a general practice‐based brief intervention for excessive drinking. Addiction (Abingdon, England) 1995;90(1):119‐32. - PubMed
Rodríguez 2003 {published data only}
    1. Dauer ARM, Rubio ES, Coris ME, Valls MJ. Brief intervention in alcohol‐positive traffic casualties: is it worth the effort?. Alcohol and Alcoholism (Oxford, Oxfordshire) 2006;41(1):76‐83. - PubMed
    1. Dauer ARM, Rubio ES, Gómez XM, Novella LT, Coris ME, Valls MJ, et al. Early identification and brief intervention in alcohol‐related traffic casualties: preliminary results [Identificación precoz e intervención breve en lesionados de trafico con presencia d alcohol: primeros resultados]. Adicciones 2003;15(3):191‐202.
    1. Rodríguez‐Martos A, Santamariña E, Torralba L, Escayola M, Martí J, Plasència A. Short‐term effectiveness of brief interventions in alcohol‐positive traffic casualties [Efectividad a corto plazo de las interventiones breves realizadas en pacientes lesionados por accidente de tráfico con alcoholemia positiva]. Gaceta Sanitaria 2005;19(1):45‐9. - PubMed
Romelsjö 1989 {published data only}
    1. Romelsjö A, Andersson L, Barrner H, Borg S, Granstrand C, Hultman O, et al. A randomized study of secondary prevention of early stage problem drinkers in primary health care. British Journal of Addiction 1989;84(11):1319‐27. - PubMed
Rubio 2010 {published data only}
    1. Rubio G, Jiménez‐Arriero MA, Martínez I, Ponce G, Palomo T. Efficacy of physician‐delivered brief counseling intervention for binge drinkers. American Journal of Medicine 2010;123(1):72‐8. - PubMed
Schaus 2009 {published data only}
    1. Schaus JF, Sole ML, McCoy TP, Mullett N, O'Brien MC. Alcohol screening and brief intervention in a college student health center: a randomized controlled trial. Journal of Studies on Alcohol and Drugs. Supplement 2009;16:131‐41. - PMC - PubMed
Scott 1990 {published data only}
    1. Anderson P, Scott E. The effect of general practitioners' advice to heavy drinking men. British Journal of Addiction 1992;87(6):891‐900. - PubMed
    1. Scott E, Anderson P. Randomized controlled trial of general practitioner intervention in women with excessive alcohol consumption. Drug and Alcohol Review 1990;10(4):313‐21. - PubMed
Segatto 2011 {published data only}
    1. Segatto ML, Andreoni S, Souza e Silva R, Diehl A, Pinsky I. Brief motivational interview and educational brochure in emergency room settings for adolescents and young adults with alcohol‐related problems: a randomized single‐blind clinical trial. Revista Brasileira de Psiquiatria (Sao Paulo, Brazil : 1999) 2011;33(3):225‐33. - PubMed
Senft 1997 {published data only}
    1. Senft RA, Polen MR, Freeborn DK, Hollis JF. Brief intervention in a primary care setting for hazardous drinkers. American Journal of Preventive Medicine 1997;13(6):464‐70. - PubMed
Seppa 1992 {published data only}
    1. Seppa K. Intervention in alcohol abuse among macrocytic patients in general practice. Scandinavian Journal of Primary Health Care 1992;10(3):217‐22. - PubMed
Soderstrom 2007 {published data only}
    1. Dischinger PC. Request for further information on the Delta study [personal communication]. Email to: FR Beyer 7 May 2014.
    1. Soderstrom CA, DiClemente CC, Dischinger PC, Hebel JR, McDuff DR, Auman KM, et al. A controlled trial of brief intervention versus brief advice for at‐risk drinking trauma center patients. Journal of Trauma 2007;62(5):1102‐11. - PubMed
Sommers 2006 {published data only}
    1. Sommers MS, Dyehouse JM, Howe SR, Fleming M, Fargo JD, Schafer JC. Effectiveness of brief interventions after alcohol‐related vehicular injury: a randomized controlled trial. Journal of Trauma 2006;61(3):523‐31. - PubMed
Sommers 2013 {published and unpublished data}
    1. Sommers MS. Effectiveness of brief alcohol interventions [personal communication]. Email to: C Muirhead 24 June 2014.
    1. Sommers MS, Lyons MS, Fargo JD, Sommers BD, McDonald CC, Shope JT, et al. Emergency department–based brief intervention to reduce risky driving and hazardous/harmful drinking in young adults: a randomized controlled trial. Alcoholism, Clinical and Experimental Research 2013;37(10):1753‐62. - PMC - PubMed
Spirito 2004 {published data only}
    1. Spirito A, Monti PM, Barnett NP, Colby SM, Sindelar H, Rohsenow DJ, et al. A randomized clinical trial of a brief motivational intervention for alcohol‐positive adolescents treated in an emergency department. Journal of Pediatrics 2004;145(3):396‐402. - PubMed
Spirito 2011 {published data only}
    1. Spirito A, Sindelar‐Manning H, Colby SM, Barnett NP, Lewander W, Rohsenow DJ, et al. Individual and family motivational interventions for alcohol‐positive adolescents treated in an emergency department: results of a randomized clinical trial. Archives of Pediatrics and Adolescent Medicine 2011;165(3):269‐74. - PMC - PubMed
Tait 2004 {published data only}
    1. Tait R. Including your trial in our Cochrane review...? [personal communication]. Email to: FR Beyer 9 October 2013.
    1. Tait RJ, Hulse GK. Adolescent substance use and hospital presentations: a record linkage assessment of 12‐month outcomes. Drug and Alcohol Dependence 2005;79(3):365‐71. - PubMed
    1. Tait RJ, Hulse GK, Robertson SI. Effectiveness of a brief‐intervention and continuity of care in enhancing attendance for treatment by adolescent substance users. Drug and Alcohol Dependence 2004;74(3):289‐96. - PubMed
    1. Tait RJ, Hulse GK, Robertson SI, Sprivulis PC. Emergency department‐based intervention with adolescent substance users: 12‐month outcomes. Drug and Alcohol Dependence 2005;79(3):359‐63. - PubMed
Tomson 1998 {published data only}
    1. Tomson Y, Romelsjö A, Aberg H. Excessive drinking ‐ brief intervention by a primary health care nurse: a randomized controlled trial. Scandinavian Journal of Primary Health Care 1998;16(3):188‐92. - PubMed
Wallace 1988 {published data only}
    1. Wallace P, Cutler S, Haines A. Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption. British Medical Journal 1988;297(6649):663‐8. - PMC - PubMed
Walton 2010 {published and unpublished data}
    1. Cunningham RM, Chermack ST, Zimmerman MA, Shope JT, Bingham CR, Blow FC, et al. Brief motivational interviewing intervention for peer violence and alcohol use in teens: one‐year follow‐up. Pediatrics 2012;129(6):1083‐90. - PMC - PubMed
    1. Cunningham RM, Walton MA, Goldstein A, Chermack ST, Shope JT, Bingham CR, et al. Three‐month follow‐up of brief computerized and therapist interventions for alcohol and violence among teens. Academic Emergency Medicine 2009;16(11):1193‐207. - PMC - PubMed
    1. Walton M. Effectiveness of brief alcohol interventions [personal communication]. Email to: C Muirhead 14 October 2014.
    1. Walton MA, Chermack ST, Shope JT, Bingham CR, Zimmerman MA, Blow FC, et al. Effects of a brief intervention for reducing violence and alcohol misuse among adolescents: a randomized controlled trial. JAMA 2010;304(5):527‐35. - PMC - PubMed
Watson 2013 {published data only}
    1. Watson J, Crosby H, Dale V, Tober G, Wu Q, Lang J, et al. AESOPS: a randomised controlled trial of the clinical effectiveness and cost‐effectiveness of opportunistic screening and stepped care interventions for older hazardous alcohol users in primary care. Health Technology Assessment 2013;17:1‐158. - PMC - PubMed
Woolard 2013 {published data only}
    1. Woolard R, Baird J, Longabaugh R, Nirenberg T, Lee CS, Mello MJ, et al. Project REDUCE: reducing alcohol and marijuana misuse: effects of a brief intervention in the Emergency Department. Addictive Behaviors 2013;38(3):1732‐9. - PMC - PubMed

References to studies excluded from this review

Academic ED SBIRT 2007 {published data only}
    1. Academic ED SBIRT Research Collaborative. The impact of screening, brief intervention and referral for treatment in emergency department patients' alcohol use: a 3‐, 6‐and 12‐month follow‐up. Alcohol and Alcoholism (Oxford, Oxfordshire) 2010;45(6):514‐9. - PMC - PubMed
    1. Academic ED SBIRT Research Collaborative. The impact of screening, brief intervention, and referral for treatment on emergency department patients' alcohol use. Annals of Emergency Medicine 2007;50(6):699‐710. - PubMed
Ameratunga 2011 {published data only}
    1. Ameratunga S, Whittaker R, Kool B, Civil I, Reid P, Thornton V, et al. Feasibility of a mobile phone delivered intervention to reduce harmful drinking and injury among trauma patients: the MoDeRATE trial. 8th Conference of INEBRIA. Boston, USA, 2011.
Apodaca 2007 {published data only}
    1. Apodaca TR, Miller WR, Schermer CR, Amrhein PC. A pilot study of bibliotherapy to reduce alcohol problems among patients in a hospital trauma center. Journal of Addictions Nursing 2007;18(4):167‐73.
Areesantichai 2010 {published data only}
    1. Areesantichai C, Iamsupasit S, Marsden J, Perngparn U, Taneepanichskul S. Effect of "tailored goal oriented community brief intervention model" on AUDIT reduction in Thai communities. Journal of the Medical Association of Thailand 2010;93(8):992‐7. - PubMed
Areesantichai 2013 {published data only}
    1. Areesantichai C, Chapman RS, Perngparn U. Effectiveness of a Tailored Goal Oriented Community Brief Intervention (TGCBI) in reducing alcohol consumption among risky drinkers in Thailand: a quasi‐experimental study. Journal of Studies on Alcohol and Drugs 2013;74(2):311‐9. - PubMed
Babor 1996 {published data only}
    1. WHO Brief Intervention Study Group. A cross‐national trial of brief interventions with heavy drinkers. American Journal of Public Health 1996;86(7):948‐55. - PMC - PubMed
Baker 2014 {published data only}
    1. Baker AL, Turner A, Kelly PJ, Spring B, Callister R, Collins CE, et al. 'Better Health Choices' by telephone: a feasibility trial of improving diet and physical activity in people diagnosed with psychotic disorders. Psychiatry Research 2014;220(1):63‐70. - PubMed
Ball 2007 {published data only}
    1. Ball SA, Todd M, Tennen H, Armeli S, Mohr C, Affleck G, et al. Brief motivational enhancement and coping skills interventions for heavy drinking. Addictive Behaviors 2007;32(6):1105‐18. - PubMed
Boekeloo 2004 {published data only}
    1. Boekeloo BO, Jerry J, Lee‐Ougo WI, Worrell KD, Hamburger EK, Russek‐Cohen E, et al. Randomized trial of brief office‐based interventions to reduce adolescent alcohol use. Archives of Pediatrics & Adolescent Medicine 2004;158(6):635‐42. - PubMed
Ceperich 2011 {published data only}
    1. Ceperich SD, Ingersoll KS. Motivational interviewing + feedback intervention to reduce alcohol‐exposed pregnancy risk among college binge drinkers: determinants and patterns of response. Journal of Behavioral Medicine 2011;34(5):381‐95. - PMC - PubMed
Chander 2015 {published data only}
    1. Chander G, Hutton HE, Lau B, Xu X, McCaul ME. Brief intervention decreases drinking frequency in HIV‐infected, heavy drinking women: results of a randomized controlled trial. Journal of Acquired Immune Deficiency Syndromes 2015;70(2):137‐45. - PMC - PubMed
Chang 1997 {published data only}
    1. Chang G, Behr H, Goetz M, Hiley A, Bigby J. Women and alcohol abuse in primary care: identification and intervention. American Journal on Addictions / American Academy of Psychiatrists in Alcoholism and Addictions 1997;6(3):183‐92. - PubMed
Field 2014 {published data only}
    1. Field C, Walters S, Marti CN, Jun J, Foreman M, Brown C. A multisite randomized controlled trial of brief intervention to reduce drinking in the trauma care setting: how brief is brief?. Annals of Surgery 2014;259(5):873‐80. - PMC - PubMed
Gentilello 1999 {published data only}
    1. Gentilello LM, Rivara FP, Donovan DM, Jurkovich GJK, Daranciang E, Dunn CW, et al. Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. Annals of Surgery 1999;230(4):473‐83. - PMC - PubMed
Gwadz 2008 {published data only}
    1. Gwadz MV, Leonard NR, Cleland CM, Riedel M, Arredondo GN, Wolfe H, et al. Behavioral interventions for HIV infected and uninfected mothers with problem drinking. Addiction Research & Theory 2008;16(1):47‐65.
Haller 2014 {published data only}
    1. Haller DM, Meynard A, Lefebvre D, Ukoumunne OC, Narring F, Broers B. Effectiveness of training family physicians to deliver a brief intervention to address excessive substance use among young patients: a cluster randomized controlled trial. CMAJ : Canadian Medical Association Journal 2014;186(8):E263‐72. - PMC - PubMed
Hansen 2012 {published data only}
    1. Hansen ABG, Becker U, Nielsen AS, Gronbaek M, Tolstrup JS, Thygesen LC. Internet‐based brief personalized feedback intervention in a non‐treatment seeking population of adult heavy drinkers: a randomized controlled trial. Journal of Medical Internet Research 2012;14(4):e98. - PMC - PubMed
Hansen 2012a {published data only}
    1. Hansen AB, Becker U, Nielsen AS, Grønbaek M, Tolstrup JS. Brief alcohol intervention by newly trained workers versus leaflets: comparison of effect in older heavy drinkers identified in a population health examination survey: a randomized controlled trial. Alcohol and Alcoholism (Oxford, Oxfordshire) 2012;47(1):25‐32. - PubMed
Hansson 2007 {published data only}
    1. Hansson H, Rundberg J, Zetterlind U, Johnsson KO, Berglund M. Two‐year outcome of an intervention program for university students who have parents with alcohol problems: a randomized controlled trial. Alcoholism, Clinical and Experimental Research 2007;31(11):1927‐33. - PubMed
Hilbink 2012 {published data only}
    1. Hilbink M, Voerman G, Beurden I, Penninx B, Laurant M. A randomized controlled trial of a tailored primary care program to reverse excessive alcohol consumption. Journal of the American Board of Family Medicine 2012;25(5):712‐22. - PubMed
Houry 2011 {published data only}
    1. Houry D, Hankin A, Daugherty J, Smith LS, Kaslow N. Effect of a targeted women's health intervention in an inner‐city emergency department. Emergency Medicine International 2011 December 10 [Epub ahead of print]. [DOI: 10.1155/2011/543493] - DOI - PMC - PubMed
Hyman 2007 {published data only}
    1. Hyman Z. Brief interventions for high‐risk drinkers. Journal of Clinical Nursing 2007;15(11):1383‐96. - PubMed
Ingersoll 2013 {published data only}
    1. Ingersoll KS, Ceperich SD, Hettema JE, Farrell‐Carnahan L, Penberthy JK. Preconceptional motivational interviewing interventions to reduce alcohol‐exposed pregnancy risk. Journal of Substance Abuse Treatment 2013;44(4):407‐16. - PMC - PubMed
Ivanets 1991 {published data only}
    1. Ivanets NN, Lukomskaya MI. Evaluation of early intervention strategies used in primary health care: a report on the World Health Organization (WHO) Project on Identification and management of alcohol‐related problems in primary health care. Alcohol and Alcoholism (Oxford, Oxfordshire). Supplement 1991;1:489‐91. - PubMed
Jessop 2008 {published data only}
    1. Jessop DC, Wade J. Fear appeals and binge drinking: a terror management theory perspective. British Journal of Health Psychology 2008;13(4):773‐88. - PubMed
Kristenson 1983 {published data only}
    1. Kristenson H, Ohlin H, Hulten‐Nosslin MB, Trell E, Hood B. Identification and intervention of heavy drinking in middle‐aged men: results and follow‐up of 24‐60 months of long‐term study with randomized controls. Alcoholism, Clinical and Experimental Research 1983;7(2):203‐9. - PubMed
Kulesza 2013 {published data only}
    1. Kulesza M, McVay MA, Larimer ME, Copeland AL. A randomized clinical trial comparing the efficacy of two active conditions of a brief intervention for heavy college drinkers. Addictive Behaviors 2013;38(4):2094‐101. - PubMed
Lang 2007 {published data only}
    1. Lang S, Kuttler H. Project HaLT [Projekt HaLT – Hart am LimiT. Frühintervention und kommunal verankerte Strategie zur Verhinderung von riskantem Rauschtrinken bei Kindern und Jugendlichen]. Viennese Journal of Addiction Research 2007;30(1):27‐37.
Maheswaran 1992 {published data only}
    1. Maheswaran R, Beevers M, Beevers DG. Effectiveness of advice to reduce alcohol consumption in hypertensive patients. Hypertension 1992;19(1):79‐84. - PubMed
Massey 2015 {published data only}
    1. Massey LS, Barry KL, Walton MA, Chermack ST, Cunningham RM, Bohnert ASB, et al. Computer and therapist delivered brief alcohol interventions for adult risky drinkers in the emergency department: health explorer study post‐test. Alcoholism, Clinical and Experimental Research 2015;39:22A.
McDevitt‐Murphy 2015 {published data only}
    1. McDevitt‐Murphy ME, Williams JL, Murphy JG, Monahan CJ, Bracken‐Minor KL. Brief intervention to reduce hazardous drinking and enhance coping among OEF/OIF/OND veterans. Professional Psychology, Research and Practice 2015;46(2):83‐9. - PMC - PubMed
Mezzani 2007 {published data only}
    1. Mezzani L, Patussi V, Rossi A, Russo R, Scafato E. Establishing an Italian general practitioner brief intervention pilot project for problem drinkers. Substance Use & Misuse 2007;42(12‐13):1979‐89. - PubMed
Milner 2010 {published data only}
    1. Milner KK, Barry KL, Blow FC, Welsh D. Brief interventions for patients presenting to the psychiatric emergency service (PES) with major mental illnesses and at‐risk drinking. Community Mental Health Journal 2010;46(2):149‐55. - PubMed
Monti 1999 {published data only}
    1. Monti PM, Spirito A, Myers MCSM, Barnett NP, Pohsenow DJ, Woolard RLW. Brief intervention for harm reduction with alcohol positive older adolescents in a hospital emergency department. Journal of Consulting and Clinical Psychology 1999;67(6):989‐94. - PubMed
Nayak 2015 {published data only}
    1. Nayak MB, Bond JC, Ye Y, Cherpitel CJ, Woolard R, Bernstein E, et al. Readiness to change and to accept help and drinking outcomes in young adults of Mexican origin. Journal of Studies on Alcohol and Drugs 2015;76(4):602‐6. - PMC - PubMed
Nilssen 1991 {published data only}
    1. Nilssen O. The Tromsø study: identification of and a controlled intervention on a population of early stage risk drinkers. Preventive Medicine 1991;20(4):518‐28. - PubMed
Pal 2007 {published data only}
    1. Pal HR, Yadav D, Mehta S, Mohan I. A comparison of brief intervention versus simple advice for alcohol use disorders in a North India community‐based sample followed for 3 months. Alcohol and Alcoholism (Oxford, Oxfordshire) 2007;42(4):328‐32. - PubMed
Palm 2016 {published data only}
    1. Palm A, Olofsson N, Danielsson I, Skalkidou A, Wennberg P, Högberg U. Motivational interviewing does not affect risk drinking among young women: a randomised, controlled intervention study in Swedish youth health centres. Scandinavian Journal of Public Health 2016;44(6):611‐8. - PubMed
Rhodes 2015 {published data only}
    1. Rhodes KV, Rodgers M, Sommers M, Hanlon A, Chittams J, Doyle A, et al. Brief motivational intervention for intimate partner violence and heavy drinking in the emergency department: a randomized clinical trial. JAMA 2015;314(5):466‐77. - PMC - PubMed
Shetty 2011 {published data only}
    1. Shetty V, Murphy DA, Zigler C, Yamashita DD, Belin TR. Randomized controlled trial of personalized motivational interventions in substance using patients with facial injuries. Journal of Oral and Maxillofacial Surgery 2011;69(9):2396‐411. - PMC - PubMed
Sterling 2017 {published data only}
    1. Sterling SA, Kline‐Simon A, Jones A, Brumder‐Ross T, Weisner C. Outcomes from a trial of screening, brief intervention and referral to treatment for adolescents in pediatric primary care: implications for adolescent girls. Alcoholism: Clinical and Experimental Research 2017;41:336A.
Toft 2009 {published data only}
    1. Toft U, Pisinger C, Aadahl M, Lau C, Linneberg A, Ladelund S, et al. The impact of a population‐based multi‐factorial lifestyle intervention on alcohol intake: the Inter99 study. Preventive Medicine 2009;49(2‐3):115‐21. - PubMed
UKATT 2005 {published data only}
    1. UKATT Research Team. Cost effectiveness of treatment for alcohol problems: findings of the randomised UK alcohol treatment trial (UKATT). BMJ (Clinical Research Ed.) 2005;331(7516):544. - PMC - PubMed
Walton 2015a {published data only}
    1. Walton MA, Chermack ST, Blow FC, Ehrlich PF, Barry KL, Booth BM, et al. Components of brief alcohol interventions for youth in the emergency department. Substance Abuse 2015;36(3):339‐49. - PMC - PubMed
Worden 2011 {published data only}
    1. Worden BL. Effectiveness of a feedback‐based brief intervention for alcohol use disorders in community care [PhD thesis]. New Jersey: Rutgers University, 2011.
Wutzke 2002 {published data only}
    1. Wutzke S, Conigrave K, Saunders J, Hall W. The long‐term effectiveness of brief interventions for unsafe alcohol consumption: a 10‐year follow‐up. Addiction 2002;97(6):665‐75. - PubMed

References to studies awaiting assessment

Arnaud 2017 {published data only}
    1. Arnaud N, Diestelkamp S, Wartberg L, Sack PM, Daubmann A, Thomasius R. Short‐ to midterm effectiveness of a brief motivational intervention to reduce alcohol use and related problems for alcohol intoxicated children and adolescents in pediatric emergency departments: a randomized controlled trial. Academic Emergency Medicine 2017;24(2):186‐200. - PubMed
Cherpitel 2016 {published data only}
    1. Cherpitel CJ, Ye Y, Bond J, Woolard R, Villalobos S, Bernstein J, et al. Brief intervention in the emergency department among Mexican‐origin young adults at the US‐Mexico border: outcomes of a randomized controlled clinical trial using promotores. Alcohol and Alcoholism (Oxford, Oxfordshire) 2016;51(2):154‐63. - PMC - PubMed
Crawford 2015 {published data only}
    1. Crawford MJ, Sanatinia R, Barrett B, Byford S, Dean M, Green J, et al. The clinical and cost‐effectiveness of brief advice for excessive alcohol consumption among people attending sexual health clinics: a randomised controlled trial. Sexually Transmitted Infections 2015;91(1):37‐43. - PMC - PubMed
Diaz Gomez 2017 {published data only}
    1. Diaz Gomez C, Ngantcha M, Garjean N, Brouard N, Lasbleiz M, Perennes M, et al. Effect of a brief motivational intervention in reducing alcohol consumption in the emergency department: a randomized controlled trial. European Journal of Emergency Medicine 2017 July 12 [Epub ahead of print]. [DOI: 10.1097/MEJ.0000000000000488] - DOI - PubMed
Mello 2016 {published data only}
    1. Mello MJ, Baird J, Lee C, Strezsak V, French MT, Longabaugh R. A randomized controlled trial of a telephone intervention for alcohol misuse with injured emergency department patients. Annals of Emergency Medicine 2016;67(2):263‐75. - PMC - PubMed
Monti 2015 {published data only}
    1. Monti PM, Mastroleo NR, Barnett NP, Colby SM, Kahler CW, Operario D. Brief motivational intervention to reduce alcohol and HIV/sexual risk behavior in emergency department patients: A randomized controlled trial. Journal of Consulting and Clinical Psychology 2016;84(7):580. - PMC - PubMed
    1. Monti PM, Mastroleo NR, Kahler CW, Barnett NB, Colby SM, Operario D. Effects of a brief intervention in the emergency department for alcohol and HIV/sexual risk. Alcoholism, Clinical and Experimental Research 2015;39:305A. - PMC - PubMed
Nadkarni 2017 {published data only}
    1. Nadkarni A, Weobong B, Weiss HA, McCambridge J, Bhat B, Katti B, et al. Counselling for Alcohol Problems (CAP), a lay counsellor‐delivered brief psychological treatment for harmful drinking in men, in primary care in India: a randomised controlled trial. Lancet 2017;389(10065):186‐95. - PMC - PubMed
Walton 2015 {published data only}
    1. Walton MA, Chermack ST, Ehrlich P, Carter P, Booth BM, Blow F, et al. Project U Connect: a randomized controlled trial testing alcohol interventions among underage drinkers in the emergency department. Alcoholism, Clinical and Experimental Research 2015;39:22A.

References to ongoing studies

ISRCTN13832949 {published data only}
    1. ISRCTN13832949. Development and evaluation of the efficacy of a brief motivational intervention among young adults admitted in the emergency room while being alcohol intoxicated [A process study and randomized controlled trial examining the efficacy and mechanisms of motivational interviewing for alcohol Intoxicated young adults admitted to the emergency room]. www.isrctn.com/ISRCTN13832949 (first received 26 November 2016).
ISRCTN45300218 {published data only}
    1. Deluca P, Coulton S, Alam MF, Cohen D, Donoghue K, Gilvarry E, et al. Linked randomised controlled trials of face‐to‐face and electronic brief intervention methods to prevent alcohol related harm in young people aged 14‐17 years presenting to Emergency Departments (SIPS Junior). BMC Public Health 2015;15(1):345. - PMC - PubMed
    1. ISRCTN45300218. Developing and evaluating interventions for adolescents with alcohol use disorders who present through emergency departments: randomised feasibility study and exploratory randomised controlled trial. www.isrctn.com/ISRCTN45300218 (first received 5 June 2014).
RBR‐65262c {published data only}
    1. RBR‐65262c. Brief intervention for hazardous and harmful women´s alcohol consumption [Intervenção breve para mulheres que fazem uso de risco ou nocivo de álcool]. www.ensaiosclinicos.gov.br/rg/RBR‐65262c/ (first received 20 March 2017).

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