Brief physician advice for problem alcohol drinkers. A randomized controlled trial in community-based primary care practices

Journal Name: 
JAMA
Authors: 
Fleming,M.F.
Barry,K.L.
Manwell,L.B.
Johnson,K.
London,R.
Abstract: 
OBJECTIVE: Project TrEAT (Trial for Early Alcohol Treatment) was designed to test the efficacy of brief physician advice in reducing alcohol use and health care utilization in problem drinkers. DESIGN: Randomized controlled clinical trial with 12-month follow-up. SETTING: A total of 17 community-based primary care practices (64 physicians) located in 10 Wisconsin counties. PARTICIPANTS: Of the 17695 patients screened for problem drinking, 482 men and 292 women met inclusion criteria and were randomized into a control (n=382) or an experimental (n=392) group. A total of 723 subjects (93%) participated in the 12- month follow-up procedures. INTERVENTION: The intervention consisted of two 10- to 15-minute counseling visits delivered by physicians using a scripted workbook that included advice, education, and contracting information. MAIN OUTCOME MEASURES: Alcohol use measures, emergency department visits, and hospital days. RESULTS: There were no significant differences between groups at baseline on alcohol use, age, socioeconomic status, smoking status, rates of depression or anxiety, frequency of conduct disorders, lifetime drug use, or health care utilization. At the time of the 12-month follow-up, there were significant reductions in 7-day alcohol use (mean number of drinks in previous 7 days decreased from 19.1 at baseline to 11.5 at 12 months for the experimental group vs 18.9 at baseline to 15.5 at 12 months for controls; t=4.33; P
4
2
1997
Volume: 
277
Pages: 
1039-45
Keywords: 
10, 4380, Adult, Alcoholism: prevention & control, Algorithms, clinical, clinical trial, Counseling, criteria, Depression, differences, disorders, drug use, education, Emergencies, Emergency Service,Hospital: utilization, Ethanol: poisoning, Family Practice, Female, Health, health care, Health Resources: utilization, Health Status, hospital, Hospitalization, Hospitalization: statistics & numerical data, Human, information, Internal Medicine, intervention, Logistic Models, Male, Middle Age, patient, Patients, Physician's Role, Physicians, Physicians,Family, primary care, Smoking, Support,Non-U.S.Gov't, Support,U.S.Gov't,P.H.S., system, utilization, Wisconsin, women, WReN