title: What are the Implications for Policy Makers? A Systematic Review of the Cost-Effectiveness of Screening and Brief Interventions for Alcohol Misuse in Primary Care.
abstract: BACKGROUND
  The efficacy of screening and brief interventions (SBIs) for excessive alcohol use in primary care is well established; however, evidence on their cost-effectiveness is limited. A small number of previous reviews have concluded that SBI programs are likely to be cost-effective but these results are equivocal and important questions around the cost-effectiveness implications of key policy decisions such as staffing choices for delivery of SBIs and the intervention duration remain unanswered.
  
  
  METHODS
  Studies reporting both the costs and a measure of health outcomes of programs combining SBIs in primary care were identified by searching MEDLINE, EMBASE, Econlit, the Cochrane Library Database (including NHS EED), CINAHL, PsycINFO, Assia and the Social Science Citation Index, and Science Citation Index via Web of Knowledge. Included studies have been stratified both by delivery staff and intervention duration and assessed for quality using the Drummond checklist for economic evaluations.
  
  
  RESULTS
  The search yielded a total of 23 papers reporting the results of 22 distinct studies. There was significant heterogeneity in methods and outcome measures between studies; however, almost all studies reported SBI programs to be cost-effective. There was no clear evidence that either the duration of the intervention or the delivery staff used had a substantial impact on this result.
  
  
  CONCLUSIONS
  This review provides strong evidence that SBI programs in primary care are a cost-effective option for tackling alcohol misuse.
authors.affiliation: School of Health and Related Research (ScHARR), University of Sheffield , Sheffield , UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Angus
authors.affiliation: School of Health and Related Research (ScHARR), University of Sheffield , Sheffield , UK.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Latimer
authors.affiliation: School of Health and Related Research (ScHARR), University of Sheffield , Sheffield , UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Preston
authors.affiliation: School of Health and Related Research (ScHARR), University of Sheffield , Sheffield , UK.
authors.forename: Jessica
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Automatic Control and Systems Engineering, University of Sheffield , Sheffield , UK.
authors.forename: Robin
authors.initials: R
authors.lastname: Purshouse
keywords: alcohol drinking; brief alcohol intervention; brief intervention; policy making; primary care; resource allocation; screening and brief intervention; systematic review