title: Randomised controlled trial of a brief alcohol intervention in a general hospital setting.
abstract: BACKGROUND
  The evidence suggests that brief alcohol-focused interventions, directed at hazardous and harmful drinkers in non-specialist settings such as primary care are effective in reducing alcohol consumption. However, there is a need for further research in the hospital setting. This is a randomised controlled trial to investigate the effectiveness of a 10-minute brief intervention amongst 'at risk' drinkers admitted to general hospital wards. Unlike some previous trials, this trial is randomised, used blinded assessors, includes an intention-to-treat analysis, included female subjects and excluded people with alcohol dependence.
  
  
  METHODS
  A total of 250 'at risk' drinkers admitted to King's College Hospital were identified using the Alcohol Use Disorders Identification Test (AUDIT). Some 154 subjects entered the study and were randomly allocated to the control and intervention groups. Subjects in the control group received no advice about their drinking whilst subjects in the intervention group received 10 minutes of simple advice on reducing alcohol consumption. Recruitment took place between 1995 and 1997. The primary outcome was the AUDIT questionnaire at 12 months. Secondary outcomes were a previous week's Drinks Diary, questionnaires (General Health Questionnaire, Alcohol Problems Questionnaire and the Severity of Alcohol Dependence Questionnaire) and laboratory blood tests (gamma glutamyl transferase, mean cell volume and haemoglobin).
  
  
  RESULTS
  At 3-month and 12-month follow-up, all participants were included in the intention-to-treat analysis. At both time points there was no evidence of an intervention effect that could be attributed to the brief intervention. Both the intervention and control groups had an improved AUDIT score and reduced levels of alcohol consumption as measured by a subjective Drinks Diary at 3 months which was maintained at 12 months.
  
  
  CONCLUSIONS
  This study has added further evidence on brief interventions in the hospital setting. In contrast to the recent Cochrane review by McQueen et al., the results of this study do not support the effectiveness of a brief alcohol intervention in general hospital wards. However our study was underpowered and there were flaws in the statistical analyses, and these limitations temper the strength of our conclusions.
authors.forename: Celia J
authors.initials: CJ
authors.lastname: Shiles
authors.forename: Una P
authors.initials: UP
authors.lastname: Canning
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Kennell-Webb
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Gunstone
authors.affiliation: Out-Patient Department, Maudsley Hospital, South London and Maudsley, NHS Foundation Trust, Alcohol Unit, C/O Room 40, Denmark Hill, London SE5 8AZ, UK. jane.marshall@slam.nhs.uk.
authors.forename: E Jane
authors.initials: EJ
authors.lastname: Marshall
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Peters
authors.forename: Simon C
authors.initials: SC
authors.lastname: Wessely
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects / Q000097:blood / Q000517:prevention & control* / Q000523:psychology; D015415:Biomarkers / Q000097:blood; D003376:Counseling; D004909:Erythrocyte Indices; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006769:Hospitals, General; D006801:Humans; D057194:Intention to Treat Analysis; D008131:London; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011237:Predictive Value of Tests; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D005723:gamma-Glutamyltransferase