Five minutes of straight talk between doctors and problem drinkers could help reduce the toll of alcohol-related injuries, violence and accidents.
Doctors have long questioned whether a single, short discussion with patients about their drinking could have significant effects on alcohol-related problems, despite dozens of studies supporting such "brief interventions." However, a new review should lay those doubts to rest.
Results showed that brief interventions reduced alcohol consumption by an average of four drinks per week. The study included 21 randomized controlled trials with 7,286 participants.
"The study confirms that relatively short and simple interventions can be quite significant in terms of reducing drinking in the general population," said lead review author Eileen Kaner, Ph.D., a senior lecturer in public health at Newcastle University in England.
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.
Although many physicians have dismissed brief interventions as applicable only to artificial research settings, Kaner found that "the studies in general are biased towards real practice" and there was no difference in the strength of the effects for studies conducted in research settings compared to those done in primary care doctors' offices or emergency rooms.
"These interventions, often as brief as five minutes, are very effective in a larger population sense at reducing alcohol consumption and are easily accomplished even within a busy primary care practice," said Fred Rotgers, Psy.D., associate professor of psychology at the Philadelphia College of Osteopathic Medicine.
Brief interventions target patients whose drinking has been found to be above safe levels , either because they have disclosed this on screening forms or because a test or injury has revealed possible alcohol-related problems.
During interventions, doctors tell patients about the harms associated with heavy drinking and the personal risk they face. They talk about specific amounts of alcohol and describe what low-risk drinking really means. They note the benefits of cutting back , as well as strategies for reducing consumption. They keep their tone nonjudgmental and matter-of-fact.
While some of the studies included more than one session, more sessions were not associated with significantly greater reductions in drinking.