The long-term effectiveness of brief interventions for unsafe alcohol consumption: a 10-year follow-up.
OBJECTIVE
To examine the long-term impact of brief and early interventions for hazardous and harmful alcohol consumption.


METHODS
A 9-month and 10-year follow-up of subjects recruited into a randomized controlled trial of a range of alcohol-related brief interventions.


METHODS
General practices, the outpatient or acute care services of a major city hospital, and a privately run health screening programmeme.


METHODS
The cohort of 554 (non-dependent) hazardous and harmful drinkers recruited into the Australian arm of the Phase II World Health Organization collaborative project on identification and treatment of persons with harmful alcohol consumption.


METHODS
The effectiveness of three forms of intervention, ranging from 5 to 60 minutes in duration, were compared with a no-treatment control condition.


METHODS
Included drinking behaviour and biological markers of alcohol use. In addition, at 10 years subjects were asked about symptoms of diagnosable alcohol use disorders and their experience of alcohol-related psychological, social and physical harm. Mortality was also assessed.


RESULTS
Results provide further evidence for the short-term effectiveness of alcohol-related brief interventions. In comparison to controls, subjects offered intervention: (1) report significantly lower consumption; and (2) less unsafe drinking at 9-month follow-up. The intensity of intervention was not related to the amount of change in drinking behaviour. Analysis at 10 years failed to find any differences in outcomes between intervention and control groups in median consumption, mean reduction in consumption from baseline to follow-up, mortality and ICD-10 diagnoses of alcohol dependence or harmful alcohol use.


CONCLUSIONS
This study failed to find evidence that brief advice and counselling without regular follow-up and reinforcement can sustain significant long-term reductions in drinking behaviour at 10-year follow-up.
Wutzke
Sonia E
SE
Faculty of Medicine, University of Sydney, Sydney, Australia. swutzke@nps.org.au
Conigrave
Katherine M
KM
Saunders
John B
JB
Hall
Wayne D
WD
D000328:Adult; D000428:Alcohol Drinking / Q000517:prevention & control*; D019973:Alcohol-Related Disorders / Q000517:prevention & control; D000437:Alcoholism / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D003376:Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers