Skip to main content

Research Repository

Advanced Search

Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): Pragmatic cluster randomised controlled trial

Kaner, E.; Bland, M.; Cassidy, P.; Coulton, S.; Dale, V.; Deluca, P.; Gilvarry, E.; Godfrey, C.; Heather, N.; Myles, J.; Newbury-Birch, D.; Oyefeso, A.; Parrott, S.; Perryman, K.; Phillips, T.; Shepherd, J.; Drummond, C.

Authors

E. Kaner

M. Bland

P. Cassidy

S. Coulton

V. Dale

P. Deluca

E. Gilvarry

C. Godfrey

N. Heather

J. Myles

D. Newbury-Birch

A. Oyefeso

S. Parrott

K. Perryman

J. Shepherd

C. Drummond



Abstract

Objective To evaluate the effectiveness of different brief intervention strategies at reducing hazardous or harmful drinking in primary care. The hypothesis was that more intensive intervention would result in a greater reduction in hazardous or harmful drinking. Design Pragmatic cluster randomised controlled trial. Setting Primary care practices in the north east and south east of England and in London. Participants 3562 patients aged 18 or more routinely presenting in primary care, of whom 2991 (84.0%) were eligible to enter the trial: 900 (30.1%) screened positive for hazardous or harmful drinking and 756 (84.0%) received a brief intervention. The sample was predominantly male (62%) and white (92%), and 34% were current smokers. Interventions Practices were randomised to three interventions, each of which built on the previous one: a patient information leaflet control group, five minutes of structured brief advice, and 20 minutes of brief lifestyle counselling. Delivery of the patient leaflet and brief advice occurred directly after screening and brief lifestyle counselling in a subsequent consultation. Main outcome measures The primary outcome was patients' self reported hazardous or harmful drinking status as measured by the alcohol use disorders identification test (AUDIT) at six months. A negative AUDIT result (score < 8) indicated non-hazardous or non-harmful drinking. Secondary outcomes were a negative AUDIT result at 12 months, experience of alcohol related problems (alcohol problems questionnaire), health utility (EQ-5D), service utilisation, and patients' motivation to change drinking behaviour (readiness to change) as measured by a modified readiness ruler. Results Patient follow-up rates were 83% at six months (n=644) and 79% at 12 months (n=617). At both time points an intention to treat analysis found no significant differences in AUDIT negative status between the three interventions. Compared with the patient informationleaflet group, the odds ratio of having a negative AUDIT result for brief advice was 0.85 (95% confidence interval 0.52 to 1.39) and for brief lifestyle counselling was 0.78 (0.48 to 1.25). A per protocol analysis confirmed these findings. Conclusions All patients received simple feedback on their screening outcome. Beyond this input, however, evidence that brief advice or brief lifestyle counselling provided important additional benefit in reducing hazardous or harmful drinking compared with the patient information leaflet was lacking. © BMJ Publishing Group Ltd 2013.

Citation

Kaner, E., Bland, M., Cassidy, P., Coulton, S., Dale, V., Deluca, P., …Drummond, C. (2013). Effectiveness of screening and brief alcohol intervention in primary care (SIPS trial): Pragmatic cluster randomised controlled trial. BMJ, 346(7892), e8501-e8501. https://doi.org/10.1136/bmj.e8501

Journal Article Type Article
Acceptance Date Nov 7, 2012
Online Publication Date Jan 9, 2013
Publication Date Jan 26, 2013
Deposit Date Jun 8, 2018
Publicly Available Date Mar 29, 2024
Journal BMJ (Online)
Print ISSN 0959-8138
Electronic ISSN 1756-1833
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 346
Issue 7892
Article Number e8501
Pages e8501-e8501
DOI https://doi.org/10.1136/bmj.e8501
Public URL https://hull-repository.worktribe.com/output/750998
Publisher URL https://www.bmj.com/content/346/bmj.e8501

Files

Article (638 Kb)
PDF

Publisher Licence URL
http://creativecommons.org/licenses/by-nc/4.0

Copyright Statement
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/bync/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.





You might also like



Downloadable Citations