[Effectiveness of medical counseling for alcoholic patients and patients with excessive alcohol consumption seen in primary care].
OBJECTIVE
To determine the effectiveness of medical counseling for alcohol abuse, when it is provided in primary care centers.


METHODS
Quasi-experimental, open, multicenter before-after study.Setting. 14 primary care physician's practices (7 rural, 7 urban) in the province of Córdoba (Spain).


METHODS
306 patients of both sexes, recruited with a case-finding strategy, who consumed >=35 (men) or >=21 (women) IU per week, or who had alcohol dependence syndrome (ADS) (MALTS score O>=11). Interventions. All patients were offered brief counseling to reduce drinking, and all were followed to evaluate their status 3 months, 1 year and 2 years later.


METHODS
The response variable was self-reported alcohol consumption together with normal GGT values or confirmation of alcohol consumption by a relative. The results were subjected to intention-to-treat analysis.


RESULTS
Of the 306 patients included in the study, 95.1% were men and 78.4% had ADS. After 2 years 38.89% (95% CI, 32.2%-44.3%) had attained their treatment goal: 23.85% were in complete abstinence, and 15.0% consumed moderate amounts of alcohol below the limit considered to indicate risk. Starting excessive consumption at less than 16 years of age (odds ratio [OR], 3.0885), living in a slum (OR, 3.2103), smoking (OR, 1.7187), and a positive CAGE test (OR, 1.9949) were associated with failure of the intervention (P<.05).


CONCLUSIONS
Counseling provided by the family doctor was highly effective under the usual conditions of general practice, both for patients with excessive alcohol consumption and for patients with con ADS.
Fernández García
J A
JA
Médico de Familia. Investigador principal. Unidad Docente de Medicina de Familia y Comunitaria de Cordoba. Spain.
Ruiz Moral
R
R
Pérula de Torres
L A
LA
Campos Sánchez
L
L
Lora Cerezo
N
N
Martínez de la Iglesia
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000517:prevention & control*; D000437:Alcoholism / Q000201:enzymology / Q000517:prevention & control*; D002648:Child; D003376:Counseling / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011320:Primary Health Care / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase