title: Alcohol brief intervention in community pharmacies: a feasibility study of outcomes and customer experiences.
abstract: BACKGROUND
  Studies indicate that community pharmacy-based alcohol brief intervention (BI) is feasible. However, few studies report significant reductions in post-BI alcohol consumption and customer experience. Cost-effectiveness has not been previously examined.
  
  
  OBJECTIVE
  This 5 month study adopted a single group pre- and post-experimental design to: (1) assess uptake of the community pharmacy alcohol BI service; (2) establish post-BI changes in alcohol consumption for hazardous drinkers; (3) report the acceptability of the service to customers who received it; and (4) undertake a preliminary economic evaluation of the service through establishing whether pharmacy-based alcohol BI affected health and social care costs, including lost employment costs, and whether it was cost-effective.
  
  
  METHODS
  26 community pharmacies in south London, UK.
  
  
  METHODS
  Trained pharmacists used the AUDIT-C and a retrospective 7-day Drinking Diary to identify risky drinkers and inform feedback and advice. Harmful drinkers were referred to their general practitioner and/or specialist alcohol services. A confidential service feedback questionnaire was completed by alcohol BI recipients. Baseline and 3-month follow-up telephone interviews were conducted with hazardous and low risk drinkers to assess post-BI alcohol use change and service cost-effectiveness.
  
  
  METHODS
  AUDIT-C, 7-day alcohol unit consumption, drinking days, cost utilisation data.
  
  
  RESULTS
  Of the 663 eligible customers offered alcohol BI, 141 (21 %) took up the service. Three-quarters of customers were identified as risky drinkers. Follow-up interviews were conducted with 61 hazardous/low risk drinkers (response rate = 58 %). Hazardous drinkers were found to significantly reduce their 7-day alcohol unit consumption and drinking days, but not AUDIT-C scores. The majority of harmful drinkers (91 %, n = 10) who were contactable post-BI had accessed further alcohol related services. Customer feedback was generally positive. Over 75 % of customers would recommend the service to others. The cost of delivering the service was estimated to be £ 134. The difference in service costs pre-BI and post-BI was not statistically significant and remained non-significant when calculated on 500 customers receiving the intervention.
  
  
  CONCLUSIONS
  Community pharmacy-based alcohol BI is a low cost service that may not have immediate beneficial impact on health and social service use, but can be effective in reducing drinking in hazardous drinkers.
authors.affiliation: King's Health Partners, Pharmaceutical Science Clinical Academic Group, Institute of Pharmaceutical Science, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK.
authors.forename: Natasha S
authors.initials: NS
authors.lastname: Khan
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Norman
authors.forename: Ranjita
authors.initials: R
authors.lastname: Dhital
authors.forename: Paul
authors.initials: P
authors.lastname: McCrone
authors.forename: Peter
authors.initials: P
authors.lastname: Milligan
authors.forename: Cate M
authors.initials: CM
authors.lastname: Whittlesea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000191:economics; D003157:Community Pharmacy Services / Q000191:economics / Q000458:organization & administration*; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008131:London; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010595:Pharmacists / Q000191:economics / Q000458:organization & administration*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D055815:Young Adult