title: A systematic review of behavioural interventions to reduce preoperative alcohol use.
abstract: OBJECTIVE
  Preoperative alcohol use is associated with an increase in postoperative morbidity and mortality. Short-term abstinence prior to elective surgery has been shown to reduce postoperative risks. Therefore, behavioural intervention (BI) targeting risky drinking may have significant utility in preventing surgical complications.
  
  
  METHODS
  The literature was systematically reviewed to identify the scope and outcomes of BIs aiming to reduce alcohol use in risky drinkers before they underwent surgery. Five databases were searched using PRISMA criteria. Of 1243 studies identified, four met pre-established inclusion criteria: (i) implementation of a BI prior to an elective surgery; (ii) the BI-targeted alcohol use among risky drinkers; and (iii) printed in English.
  
  
  RESULTS
  Two studies indicated significant reductions in alcohol use at follow ups, and one study demonstrated reductions in postoperative risks. These findings are encouraging, but in light of methodological limitations, the efficacy of preoperative BIs for risky drinking could not be determined.
  
  
  CONCLUSIONS
  Future efforts to screen and implement BIs addressing alcohol use in preoperative patients should carefully define risky drinking, allow ample time for recruitment prior to surgery, implement empirically supported interventions, examine the impact of relevant covariates, and consider the statistical power needed to detect change in postoperative complications.
  
  
  CONCLUSIONS
  Given the strong link between preoperative alcohol use and postoperative risks, additional research on preoperative BIs is critically needed. Existing research suggests several promising directions for research that may enhance future intervention efforts with this high-risk population. [Fernandez AC, Claborn KR, Borsari B. A systematic review of behavioural interventions to reduce preoperative alcohol use. Drug Alcohol Rev 2015;34:508-20].
authors.affiliation: Brown School of Public Health, Center for Alcohol and Addiction Studies, Providence, USA.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Fernandez
authors.affiliation: Brown School of Public Health, Center for Alcohol and Addiction Studies, Providence, USA.
authors.forename: Kasey R
authors.initials: KR
authors.lastname: Claborn
authors.affiliation: Brown School of Public Health, Center for Alcohol and Addiction Studies, Providence, USA.|Mental Health and Behavioral Sciences Service, Providence Veteran's Affairs Medical Center, Providence, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Borsari
keywords: alcohol drinking; behavioural medicine; brief psychotherapy; elective surgical procedure; preoperative period