Abstract
BackgroundBrief interventions have well-established small effects on alcohol consumption among hazardous and harmful drinkers in primary care, and national large-scale programmes are being implemented in many countries for public health reasons.MethodsThis paper examines data from reviews and draws upon older brief intervention studies and recent developments in the literature on motivational interviewing to consider the capacity of brief interventions to benefit those with problems, including those with severe problems.ResultsEffects on alcohol problems have been shown much less consistently, and evidence cannot be claimed to be strong for any outcomes other than reduced consumption. Combinations of advice and motivational interviewing are a promising target for evaluation in trials, and more detailed studies of the conduct of brief interventions are needed.ConclusionsWe propose that brief interventions in primary care may be more effective if they offer appropriate content in a person-centred manner, addressing patient concerns more directly.
Highlights
Primary care was the key setting for the major World Health Organization (WHO) collaborative project that developed the Alcohol Use Disorders Identification Test (AUDIT) screening instrument [1] and undertook the first cross-national brief intervention trial [2]
After approximately 30 years of study [3,4], the effects of brief interventions in primary care are, to some extent, well established [5], while evidence has been much slower to accumulate in other health and non-health settings [6]
While this proposal is congruent with the highly person-centred nature of motivational interviewing (MI) and lends itself to evaluation in trials, there are other ways in which this type of intervention content can be delivered and evaluated, and there is a particular need for detailed study of how discussions about alcohol in primary care take place
Summary
This paper examines data from reviews and draws upon older brief intervention studies and recent developments in the literature on motivational interviewing to consider the capacity of brief interventions to benefit those with problems, including those with severe problems
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