title: The effectiveness of brief alcohol interventions delivered by community pharmacists: randomized controlled trial.
abstract: OBJECTIVE
  To undertake the first randomized controlled trial to evaluate the effectiveness of a brief intervention delivered by community pharmacists to reduce hazardous or harmful drinking.
  
  
  METHODS
  This parallel group randomized trial allocated participants individually to brief alcohol intervention (n = 205) or a leaflet-only control condition (n = 202), with follow-up study after 3 months.
  
  
  METHODS
  Sixteen community pharmacies in one London Borough, UK.
  
  
  METHODS
  A total of 407 pharmacy customers (aged 18 years or over) with Alcohol Use Disorder Identification Test (AUDIT) scores 8-19, inclusive.
  
  
  METHODS
  A brief motivational discussion of approximately 10 minutes' duration, for which 17 pharmacists received a half-day of training.
  
  
  METHODS
  Hazardous or harmful drinking was assessed using the AUDIT administered by telephone by a researcher blind to allocation status. The two primary outcomes were: (1) change in AUDIT total scores and (2) the proportions no longer hazardous or harmful drinkers (scoring < 8) at 3 months. The four secondary outcomes were: the three subscale scores of the AUDIT (for consumption, problems and dependence) and health status according to the EQ-5D (a standardized instrument for use as a measure of health outcome).
  
  
  RESULTS
  At 3 months 326 (80% overall; 82% intervention, 78% control) participants were followed-up. The difference in reduction in total AUDIT score (intervention minus control) was -0.57, 95% confidence interval (CI) = -1.59 to 0.45, P = 0.28. The odds ratio for AUDIT ˂ 8 (control as reference) was 0.87, 95% CI = 0.50 to 1.51, P = 0.61). For two of the four secondary outcomes (dependence score: -0.46, 95% CI = -0.82 to -0.09, P = 0.014; health status score: -0.09, 95% CI = -0.16 to -0.02, P = 0.013) the control group did better, and in the other two there were no differences (consumption score: -0.05, 95% CI = -0.54 to 0.44, P = 0.85; non-dependence problems score: -0.13, 95% CI = -0.66 to 0.41). Sensitivity analyses did not change these findings.
  
  
  CONCLUSIONS
  A brief intervention delivered by community pharmacists appears to have had no effect in reducing hazardous or harmful alcohol consumption.
authors.affiliation: King's College London, Florence Nightingale Faculty of Nursing and Midwifery, London, UK.
authors.forename: Ranjita
authors.initials: R
authors.lastname: Dhital
authors.affiliation: King's College London, Florence Nightingale Faculty of Nursing and Midwifery, London, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Norman
authors.affiliation: School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK.
authors.forename: Cate
authors.initials: C
authors.lastname: Whittlesea
authors.affiliation: King's College London, Florence Nightingale Faculty of Nursing and Midwifery, London, UK.
authors.forename: Trevor
authors.initials: T
authors.lastname: Murrells
authors.affiliation: Mental Health and Addictions Research Group, Department of Health Sciences, Faculty of Science, University of York, York, UK.
authors.forename: Jim
authors.initials: J
authors.lastname: McCambridge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000628:therapy*; D003157:Community Pharmacy Services; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D062405:Motivational Interviewing / Q000379:methods*; D010174:Pamphlets; D010353:Patient Education as Topic; D010595:Pharmacists; D006113:United Kingdom; D055815:Young Adult
keywords: Alcohol; brief intervention; community pharmacist; community pharmacy; hazardous and harmful drinking