Promoting brief alcohol intervention by nurses in primary care: a cluster randomised controlled trial

Patient Educ Couns. 2003 Nov;51(3):277-84. doi: 10.1016/s0738-3991(02)00242-2.

Abstract

This trial evaluated the clinical impact and cost-effectiveness of strategies promoting screening and brief alcohol intervention (SBI) by nurses in primary care. Randomisation was at the level of the practice and the interventions were: written guidelines (controls, n=76); outreach training (n=68); and training plus telephone-based support (n=68). After 3 months, just 39% of controls implemented the SBI programme compared to 74% of nurses in trained practices and 71% in trained and supported practices. Controls also screened fewer patients and delivered fewer brief interventions to risk drinkers than other colleagues. However, there was a trade-off between the extent and the appropriateness of brief intervention delivery with controls displaying the least errors in overall patient management. Thus cost-effectiveness ratios (cost per patient appropriately treated) were similar between the three strategies. Given the potential for anxiety due to misdirected advice about alcohol-related risk, the balance of evidence favoured the use of written guidelines to promote SBI by nurses in primary care.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcoholism / nursing
  • Alcoholism / prevention & control*
  • Cluster Analysis
  • Cost-Benefit Analysis
  • Counseling / organization & administration*
  • Education, Nursing, Continuing
  • England
  • Family Practice / organization & administration
  • Female
  • Humans
  • Inservice Training
  • Male
  • Mass Screening / nursing
  • Mass Screening / organization & administration*
  • Middle Aged
  • Nursing Evaluation Research
  • Nursing Staff / education
  • Practice Guidelines as Topic
  • Primary Health Care / organization & administration*
  • Program Evaluation
  • Psychotherapy, Brief / organization & administration*