title: Changes in drinking behavior among control group participants in early intervention studies targeting unhealthy alcohol use recruited in general hospitals and general practices.
abstract: BACKGROUND
  This study aims to analyze the influence of setting variables on drinking behavior in patients with unhealthy alcohol consumption recruited proactively in general medical practices (GP) and internal and surgical wards of two general hospitals (GH) assigned to control groups.
  
  
  METHODS
  This analysis compared two control groups of RCTs targeting unhealthy alcohol consumption: one outpatient sample (GP; n=99) with one inpatient sample (GH; n=173). Both groups were recruited via systematic screening of all patients aged between 18 and 64 years and were included in the studies if drank above the at-risk criteria of the British Medical Association (20/30 g alcohol/daily) and/or fulfilled criteria of alcohol abuse or - dependence according to DSM-IV. Both samples received a non-alcohol specific brochure on healthy living after study inclusion and were re-assessed 12 months later.
  
  
  RESULTS
  GH patients were significantly older, included of more males, had received less schooling and had a higher readiness to change at baseline than GP patients. Groups did not differ concerning alcohol-related diagnoses or smoking status. At the 12-month follow-up, significantly more GH patients revealed abstinence or drinking below the inclusion criteria (50.0% vs. 26.1%, p<.001). In a multivariate analysis, medical setting (GH vs. GP) remained a significant predictor for non-problematic drinking or abstinence even after controlling for baseline differences between groups.
  
  
  CONCLUSIONS
  Findings suggest that untreated change from problematic alcohol use may be more intense after non-alcohol-related inpatient treatment than after having been a GP patient. Implications for brief interventions in inpatients are discussed.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee 160, 23538 Luebeck, Germany. gallus.bischof@psychiatrie.uk-sh.de
authors.forename: G
authors.initials: G
authors.lastname: Bischof
authors.forename: J
authors.initials: J
authors.lastname: Freyer-Adam
authors.forename: C
authors.initials: C
authors.lastname: Meyer
authors.forename: U
authors.initials: U
authors.lastname: John
authors.forename: H-J
authors.initials: HJ
authors.lastname: Rumpf
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D000437:Alcoholism / Q000523:psychology* / Q000534:rehabilitation*; D003657:Decision Making; D039721:Diagnostic and Statistical Manual of Mental Disorders; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D058006:General Practice; D005858:Germany; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D018579:Patient Selection; D020377:Self Efficacy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult