Table 2 Characteristics and results of studies of screening and brief intervention in general practice for excess alcohol consumption included for meta-analysis


Study (country; participants)

Screening method and when administered

Definition of excessive drinking*

No screened; screened positive (%); randomised (%)

Mean (SD) drinks per week at baseline

Intervention

Treatment goal (maximum drinks*/week)

Follow up period

Difference between groups for main outcomes as reported in the paper

Manwell (USA; women aged 18-40)28 Lifestyle questionnaire administered during consultation >11/week or >=5/occasion; 2 positive answers to CAGE 5979; 730 (12); 205 (3.4) 14 (9) Physician advice (15 min)x2; telephone boosterx2; self help material 13 4 years Change in No of drinks/week: -1.7 (P=0.0039){dagger}

ARR for binge drinking: 3.4% (P=0.0021){dagger}

















ARR for drinking above limits: 11% (P=0.05){dagger}

Scott (UK; women aged 17-69)29 Health questionnaire administered during consultation; some patients invited for first screening by mail or telephone >17/week 11521; 384 (3.3); 104§ (0.9) 30 (10) Physician advice (10 min)x1; self help material 12 1 year Change in No of drinks/week: -1.1 (NS)

ARR for binge drinking: 1.6% (NS)

















ARR for drinking above limits: 3.3% (NS)

Fleming (USA; men and women aged over 65)435 Health questionnaire administered during consultation >11/week or >=4/occasion (men), >8/week or >=4/occasion (women); or 2 positive answers to CAGE 6073; 656 (11); 158 (2.6) 16 (9) Physician advice (10-15 min)x2; telephone booster x2; self help material 20 (men), 13 (women) 1 year Change in No of drinks/week: -5.3 (P<0.001){ddagger}

ARR for binge drinking: 59% (P<0.005){ddagger}

















ARR for drinking above limits: 63% (P<0.005){ddagger}

Ockene (USA; men and women aged 21-84)30 Health questionnaire administered during consultation; some patients invited for first screening by mail or telephone >12/week or >=5/occasion (men), >9/week (women); or >=4/occasion or 2 positive answers to CAGE 9772; 1760 (18); 530 (5.4) 20 (15)men; 13 (7) women Physician or nurse advice (5-10 min)x1; self help material 12 (men), 9 (women) 0.5 year Change in No of drinks/week: -2.4 (P=0.001)

ARR for binge drinking: 5.0% (P=0.32)

















ARR for drinking above limits: 20% (P=0.01)

Fleming (USA; men and women aged 18-65)34 Health questionnaire administered during consultation >14/week (men), >11/week (women) 17695; 2925 (17); 774 (4.4) 22 (13) men; 15 (10) women Physician advice (15 min)x2; telephone booster x2; self help material 20 (men), 13 (women) 1 year Change in No of drinks/week: -3.5 (P<0.01){ddagger}

ARR for binge drinking: 17% (P<0.02){ddagger}

















ARR for drinking above limits: 30% (P<0001){ddagger}

Richmond (Australia; men and women aged 18-70)33 Health questionnaire administered during consultation >29/week (men), >17/week (women) 13017; 894 (6.9); 378§ (2.9) 42 (24) men; 22 (14) women Physician advice (5-20 min)x1-5; self help material 23 (men), 12 (women) 1 year Change in consumption: -0.3 (NS)

















Temporary effect on problem score

Wallace (UK; men and women aged 17-69)31 Health questionnaire administered during consultation; some patients invited for first screening by mail >22/week (men), >13/week (women) 62153; 4454 (7.2); 909 (1.5) 42 (21) men; 24 (12) women Physician advice (few min)x1-5; self help material 22 (men), 13 (women) 1 year Change in No of drinks/week: men -6.7 (P<0.001); women -3.5 (P<0.05)

















ARR for drinking above limits: men 18% (P<0.001); women 18% (P<0.05)

Anderson (UK; men aged 17-69)32 Health questionnaire administered during consultation; some patients invited for first screening by mail >29/week 8483; 524 (6.2); 259§ (3.1) 44 (11) Physician advice (10 min)x1; self help material 18 1 year Change in No of drinks/week -5.4 (P<0.06)

ARR for binge drinking: 30% (P<0.05)

















ARR for drinking above limits: 13% (P<0.05)

ARR=absolute risk reduction; NS=not significant; CAGE is a four questions screening test (Cut-down contemplations, annoyed by criticism, Guilt after drinking, and use of Eye-opener to steady nerves).

* Number of standard drinks (12 g alcohol) per week or per occasion.

{dagger} P values based on repeated measures test.

§ More than two arms in study.

{ddagger} P values apply to tests for difference in means or homogeneity of proportions.




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