World
Health Organization Collaborative Project on Identification and Management
of Alcohol-related Problems
in
Primary Health Care
Phase IV
Development of Country-wide Strategies for Implementing Early Identification and Brief Alcohol Intervention in Primary Health Care.
Phase II
Phase II of the project was a cross-national randomised controlled trial to evaluate the effectiveness of brief alcohol interventions in primary health care.
Ten countries (Australia, Bulgaria, Costa Rica, Kenya, Mexico, Norway, the former Soviet Union, UK, USA and Zimbabwe) were involved, recruiting a total of 1655 heavy (but not severely dependent) drinkers to the study. In the core design, participants were randomly allocated to one of three groups: a control group who received a 20 minute assessment but no intervention; a simple advice group who received assessment followed by 5 minutes of advice and a leaflet about sensible drinking; or a brief counselling group who received assessment followed by 20 minutes of counselling.
For male participants, the results showed a significant reduction in reported levels of alcohol consumption at follow-up for both the intervention groups, with 5 minutes of simple advice being as effective as 20 minutes of brief counselling. Participants in the intervention groups reduced their alcohol consumption by nearly 25% compared with the control group.
For female participants this reduction was around 10% compared with the control group. However, there were significant reductions in both intervention and control groups, suggesting that for women there may be an effect from the assessment itself.
Overall, it has been estimated that around 20% of patients identified as hazardous or harmful drinkers who receive a brief intervention will reduce their alcohol consumption.
For more information on Phase II of the project and the effectiveness of brief alcohol interventions, please see the references below:
Babor TF, Grant M. et al. A randomized clinical trial of brief interventions in primary health care: summary of a WHO project. Addiction. 1994; 89:657-678.
Bien TH, Miller WR, Tonigan JS. Brief interventions for alcohol problems: A review. Addiction. 1993; 88:315-336.
Heather N. (1995) Brief intervention strategies. In R.K. Hester and W.R. Miller (Eds.) Handbook of Alcoholism Treatment Approaches: Effective Alternatives (2nd Edition). Needham heights, MA: Allyn & Bacon.
Heather N. (1998) Using brief opportunities for change in medical settings. In W.R. Miller and N. Heather (Eds.) Treating Addictive Behaviours (2nd Edition). New York: Plenum Press.
World Health Organization. Project on identification and management of alcohol-related problems. Report on phase II: a randomized clinical trial of brief interventions in primary health care. 1992. WHO/PSA/91. WHO, Geneva.
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