RCT of effectiveness of motivational enhancement therapy delivered by nurses for hazardous drinkers in primary care units in Thailand.
OBJECTIVE
To determine the effectiveness of Motivational Enhancement Therapy (MET) for hazardous drinkers in Primary Care Unit (PCU) settings in rural Thailand.


METHODS
A randomized controlled trial was conducted in eight PCUs in Ubonratchatanee and Chachoengsao provinces in Thailand. Hazardous drinkers were identified using the World Health Organization-recommended Alcohol Use Disorder Identification Test. Of 117 eligible participants (91% male), 59 were randomized to the intervention group to receive MET in three individual appointments with a trained nurse and 58 to an assessment-only control group. Outcome evaluations were carried out after 6 weeks, 3 months and 6 months.


RESULTS
Follow-up data were available on 84, 94 and 91% of subjects, respectively, at the three intervals. Self-reported drinks per drinking day, frequency of hazardous drinking assessed either on a daily or weekly basis, and of binge drinking sessions were reduced in the intervention group more than in the control group (P < 0.05) after both 3 and 6 months. The groups did not generally differ at 6 weeks. However, although self-reported consumption in both groups fell from baseline to 6-month follow-up, serum gamma-glutamyl transferase increased in both groups, which raises doubts about the validity of this marker in this sample and/or the validity of the self-reported data in this study.


CONCLUSIONS
MET delivered by nurses in PCUs in Thailand appears to be an effective intervention for male hazardous drinkers. Uncertainties about the validity of self-reported data jeopardize the safety of this conclusion.
Department of Social Medicine, Chonburi Hospital and Medical Education Center, Chonburi, 20000, Thailand. beelittlebird@yahoo.com
Sairat
S
Noknoy
Ram
R
Rangsin
Pichai
P
Saengcharnchai
Usa
U
Tantibhaedhyangkul
Jim
J
McCambridge
D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D015415:Biomarkers / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009726:Nurses; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy / Q000379:methods*; D018401:Sample Size; D013785:Thailand; D016896:Treatment Outcome; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
D015415:Biomarkers; D005723:gamma-Glutamyltransferase