Effectiveness of brief alcohol interventions in primary care populations [Review] / E. F. S. KANER ; F. R. BEYER ; C. MUIRHEAD ; F. CAMPBELL ; E. D. PIENAAR ; N. BERTHOLET ; J. B. DAEPPEN ; J. B. SAUNDERS ; B. BURNAND in Cochrane Database of Systematic Reviews, n°2 (2018)

Donner un avis [article]  inCochrane Database of Systematic Reviews > n°2 (2018) . - CD004148 ; 252 p. Titre : Effectiveness of brief alcohol interventions in primary care populations [Review] Type de document : Périodique Auteurs : E. F. S. KANER ; F. R. BEYER ; C. MUIRHEAD ; F. CAMPBELL ; E. D. PIENAAR ; N. BERTHOLET ; J. B. DAEPPEN ; J. B. SAUNDERS ; B. BURNAND Année de publication : 2018 Article en page(s) : CD004148 ; 252 p. Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE INTERVENTION BREVE ; ALCOOL ; EFFICACITE ; REPERAGE PRECOCE ; MEDECIN GENERALISTE ; URGENCE ; SOINS DE PREMIER RECOURS ; USAGE PROBLEMATIQUE ; INTERVENTION Discipline : TRA Traitement et prise en charge / Treatment and care Résumé : What is the aim of this review? We aimed to find out whether brief interventions with doctors and nurses in general practices or emergency care can reduce heavy drinking. We assessed the findings from 69 trials that involved a total of 33,642 participants; of these 34 studies (15,197 participants) provided data for the main analysis. Key messages: Brief interventions in primary care settings aim to reduce heavy drinking compared to people who received usual care or brief written information. Longer interventions probably make little or no difference to heavy drinking compared to brief intervention. What was studied in the review? One way to reduce heavy drinking may be for doctors and nurses to provide brief advice or brief counselling to targeted people who consult general practitioners or other primary health care providers. People seeking primary healthcare are routinely asked about their drinking behaviour because alcohol use can affect many health conditions. Brief interventions typically include feedback on alcohol use and health-related harms, identification of high risk situations for heavy drinking, simple advice about how to cut down drinking, strategies that can increase motivation to change drinking behaviour, and the development of a personal plan to reduce drinking. Brief interventions are designed to be delivered in regular consultations, which are often 5 to 15 minutes with doctors and around 20 to 30 minutes with nurses. Although short in duration, brief interventions can be delivered in one to five sessions. We did not include digital interventions in this review. Search date: The evidence is current to September 2017. Study funding: Funding sources were reported by 60 (87%) studies. Of these, 58 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. Nine studies did not report study funding sources. What are the main results of the review? We included 69 controlled trials conducted in many countries. Most studies were conducted in general practice and emergency care. Study participants received brief intervention or usual care or written information about alcohol (control group). The amount of alcohol people drank each week was reported by 34 trials (15,197 participants) at one-year follow-up and showed that people who received the brief intervention drank less than control group participants (moderate-quality evidence). The reduction was around a pint of beer (475 mL) or a third of a bottle of wine (250 mL) less each week. Longer counselling probably provided little additional benefit compared to brief intervention or no intervention. One trial reported that the intervention adversely affected binge drinking for women, and two reported that no adverse effects resulted from receiving brief interventions. Most studies did not mention adverse effects. Quality of the evidence: Findings may have been affected because participants and practitioners were often aware that brief interventions focused on alcohol. Furthermore, some participants could not be contacted at one-year follow-up to report drinking levels. Overall, evidence was assessed as mostly moderate-quality. This means the reported effect size and direction is likely to be close to the true effect of these interventions. Domaine : Alcool / Alcohol Sous-type de document : Revue de la littérature / Literature review Affiliation : Institute of Health and Society, Newcastle University, Richardson Road, Newcastle upon Tyne, UK Permalink : https://bdoc.ofdt.fr/index.php?lvl=notice_display&id=80148 [article]

Titre précédent

• Effectiveness of brief alcohol interventions in primary care populations (Review) / E. F. S. KANER in Cochrane Database of Systematic Reviews, n°2 (2007)

Effectiveness of brief alcohol interventions in primary care populations (Review) / E. F. S. KANER in Cochrane Database of Systematic Reviews, n°2 (2007)

Donner un avis [article]  inCochrane Database of Systematic Reviews > n°2 (2007) . - CD004148 ; 73 p. Titre : Effectiveness of brief alcohol interventions in primary care populations (Review) Titre traduit : (Efficacité d'interventions brèves sur l'alcool auprès de populations en soins primaires (Revue de la littérature).) Type de document : Périodique Auteurs : E. F. S. KANER ; F. BEYER ; H. O. DICKINSON ; E. PIENAAR ; F. CAMPBELL ; C. SCHLESINGER ; N. HEATHER ; J. SAUNDERS ; B. BURNAND Année de publication : 2007 Article en page(s) : CD004148 ; 73 p. Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE ALCOOL ; INTERVENTION BREVE ; INTERVENTION ; SOINS DE PREMIER RECOURS ; EFFICACITE Discipline : TRA Traitement et prise en charge / Treatment and care Résumé : BACKGROUND: Many trials reported that brief interventions are effective in reducing excessive drinking. However, some trials have been criticised for being clinically unrepresentative and unable to inform clinical practice. OBJECTIVES: To assess the effectiveness of brief intervention, delivered in general practice or based primary care, to reduce alcohol consumption. SEARCH STRATEGY: We searched the Cochrane Drug and Alcohol Group specialised register (February 2006), MEDLINE (1966 to February 2006), EMBASE (1980 to February 2006), CINAHL (1982 to February 2006), PsycINFO (1840 to February 2006), Science Citation Index (1970 to February 2006), Social Science Citation Index (1970 to February 2006), Alcohol and Alcohol Problems Science Database (1972 to 2003), reference lists of articles. SELECTION CRITERIA: Randomised controlled trials, patients presenting to primary care not specifically for alcohol treatment; brief intervention of up to four sessions. DATA COLLECTION AND ANALYSIS: Two authors independently abstracted data and assessed trial quality. Random effects meta-analyses, sub-group, sensitivity analyses, and meta-regression were conducted. MAIN RESULTS: The meta-analysis included 21 RCTs (7,286 participants), showing that participants receiving brief intervention reduced their alcohol consumption compared to the control group (mean difference: -41 grams/week, 95% CI: -57 to -25), although there was substantial heterogeneity between trials (I2 = 52%). Sub-group analysis (8 studies, 2307 participants) confirmed the benefit of brief intervention in men (mean difference: -57 grams/week, 95% CI: -89 to -25, I2 = 56%), but not in women (mean difference: -10 grams/week, 95% CI: -48 to 29, I2 = 45%). Meta-regression showed a non-significant trend of an increased reduction in alcohol consumption of 1.1, 95%CI: -0.05 to 2.2 grams/week, p=0.06, for each extra minute of treatment exposure, but no relationship between the reduction in alcohol consumption and the efficacy score of the trial. Extended intervention when compared with brief intervention was associated with a non-significantly greater reduction in alcohol consumption (mean difference = -28, 95%CI: -62 to 6 grams/week, I2 = 0%) AUTHORS' CONCLUSIONS: Brief interventions consistently produced reductions in alcohol consumption. When data were available by gender, the effect was clear in men at one year of follow up, but unproven in women. Longer duration of counselling probably has little additional effect. The lack of differences in outcomes between efficacy and effectiveness trials suggests that the current literature had clear relevance to routine primary care. Future trials should focus on women and on delineating the most effective components of interventions. Domaine : Alcool / Alcohol Sous-type de document : Revue de la littérature / Literature review Refs biblio. : 100 Affiliation : University of Newcastle upon Tyne, Primary Health Care/Centre for Health Services Research, 21 Claremont Place, Newcastle upon Tyne, NE2 4AA. Royaume-Uni. United Kingdom. Numéro Toxibase : 1302453 Centre Emetteur : 13 OFDT Cote : A03573 Permalink : https://bdoc.ofdt.fr/index.php?lvl=notice_display&id=52808 [article]

Titre suivant

• Effectiveness of brief alcohol interventions in primary care populations [Review] / E. F. S. KANER ; F. R. BEYER ; C. MUIRHEAD ; F. CAMPBELL ; E. D. PIENAAR ; N. BERTHOLET ; J. B. DAEPPEN ; J. B. SAUNDERS ; B. BURNAND in Cochrane Database of Systematic Reviews, n°2 (2018)

The effectiveness of brief alcohol interventions in primary care settings: a systematic review / E. F. S. KANER ; H. O. DICKINSON ; F. BEYER ; E. PIENAAR ; C. SCHLESINGER ; F. CAMPBELL ; J. B. SAUNDERS ; B. BURNAND ; N. HEATHER in Drug and Alcohol Review, Vol.28, n°3 (May 2009)  

Donner un avis [article]  inDrug and Alcohol Review > Vol.28, n°3 (May 2009) . - 301-323 Titre : The effectiveness of brief alcohol interventions in primary care settings: a systematic review Type de document : Périodique Auteurs : E. F. S. KANER ; H. O. DICKINSON ; F. BEYER ; E. PIENAAR ; C. SCHLESINGER ; F. CAMPBELL ; J. B. SAUNDERS ; B. BURNAND ; N. HEATHER Année de publication : 2009 Article en page(s) : 301-323 Langues : Anglais (eng) Mots-clés : Thésaurus TOXIBASE ALCOOL ; INTERVENTION BREVE ; SOINS DE PREMIER RECOURS ; EFFICACITE ; REDUCTION DE CONSOMMATION ; DIFFERENCE DE GENRE Discipline : TRA Traitement et prise en charge / Treatment and care Résumé : ISSUES: Numerous studies have reported that brief interventions delivered in primary care are effective in reducing excessive drinking. However, much of this work has been criticised for being clinically unrepresentative. This review aimed to assess the effectiveness of brief interventions in primary care and determine if outcomes differ between efficacy and effectiveness trials. APPROACH: A pre-specified search strategy was used to search all relevant electronic databases up to 2006. We also hand-searched the reference lists of key articles and reviews. We included randomised controlled trials (RCT) involving patients in primary care who were not seeking alcohol treatment and who received brief intervention. Two authors independently abstracted data and assessed trial quality. Random effects meta-analyses, subgroup and sensitivity analyses and meta-regression were conducted. KEY FINDINGS: The primary meta-analysis included 22 RCT and evaluated outcomes in over 5800 patients. At 1 year follow up, patients receiving brief intervention had a significant reduction in alcohol consumption compared with controls [mean difference: -38 g week(-1), 95%CI (confidence interval): -54 to -23], although there was substantial heterogeneity between trials (I(2) = 57%). Subgroup analysis confirmed the benefit of brief intervention in men but not in women. Extended intervention was associated with a non-significantly increased reduction in alcohol consumption compared with brief intervention. There was no significant difference in effect sizes for efficacy and effectiveness trials. CONCLUSIONS: Brief interventions can reduce alcohol consumption in men, with benefit at a year after intervention, but they are unproven in women for whom there is insufficient research data. Longer counselling has little additional effect over brief intervention. The lack of differences in outcomes between efficacy and effectiveness trials suggests that the current literature is relevant to routine primary care. Domaine : Alcool / Alcohol Sous-type de document : Méta-analyse / Meta-analysis ; Revue de la littérature / Literature review Affiliation : Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK Cote : Abonnement Lien : http://dx.doi.org/10.1111/j.1465-3362.2009.00071.x Permalink : https://bdoc.ofdt.fr/index.php?lvl=notice_display&id=72256 [article]