Academic journal article Alcohol Research

Brief Intervention in Primary Care Settings: A Primary Treatment Method for At-Risk Problem, and Dependent Drinkers

Academic journal article Alcohol Research

Brief Intervention in Primary Care Settings: A Primary Treatment Method for At-Risk Problem, and Dependent Drinkers

Article excerpt

Primary health care providers identify and treat many patients who are at risk for or are already experiencing alcohol-related problems. Brief interventions-counseling delivered by primary care providers in the context of several standard office visits-can be a successful treatment approach for many of these patients. Numerous trials involving a variety of patient populations have indicated that brief interventions can reduce patients' drinking levels, regardless of the patients' ages and gender. In clinical practice, brief interventions can help reduce the drinking levels of nondependent drinkers who drink more than the recommended limits, facilitate therapy and abstinence in patients receiving pharmacotherapy, and enhance the effectiveness of assessment and treatment referral in patients who do not respond to brief interventions alone. Despite the evidence for their usefulness, however, brief interventions for alcohol-related problems have not yet been widely implemented in primary care settings.

KEY WORDS: primary health care; intervention; risk factors; problematic AOD (alcohol and other drug) use; AOD dependence; amount of AOD use; treatment outcome; AOD abstinence; drug therapy; psychological counseling; treatment barriers; physician; AOD education; health care delivery; health care cost; social cost of AODU (alcohol and other drug use); literature review

Most Americans consume alcohol at least occasionally, and results from the National Household Survey (U.S. Department of Health and Human Services 1998) suggest that as many as 40 million Americans drink more than the moderate drinking levels recommended by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) (1995). These drinkers are considered at-risk, problem, or dependent alcohol users (for definitions of different types of alcohol use, see textbox on p. 129).

Many people who are at risk for, or who are already experiencing, alcoholrelated social and medical problems do not consult alcoholism treatment specialists but receive their health care from a primary care provider. Consequently, primary care settings offer an important opportunity to identify and treat people with potential drinking problems. Epidemiological analyses underscore the notion that primary care settings are pivotal in helping people with alcoholrelated problems. For example, a prevalence study conducted in primary care settings found that 20 percent of male patients and 10 percent of female patients who came to see their physicians met the criteria for at-risk, problem, or dependent alcohol use (Manwell et al. 1998). Furthermore, 70 percent of American adults visit a physician at least once every 2 years for a routine physical examination or a specific health problem, suggesting that primary care providers potentially can identify and treat a substantial proportion of people experiencing alcohol-related adverse effects.

One treatment method that has proved to be effective in primary care settings is physician-delivered brief intervention (Fleming et al. 1997, 1999; Ockene et al. in press). This article describes the brief intervention approach, its essential components, and evidence for its effectiveness. In addition, the article discusses the current application of brief intervention in the U.S. health care system as well as barriers to its implementation. Finally, the article proposes measures that may help overcome those barriers.

ESSENTIAL ELEMENTS

OF BRIEF INTERVENTION

The term "brief intervention" refers to a time-limited, patient-centered counseling strategy that focuses on changing patient behavior and increasing patient compliance with therapy. Although this article focuses on the use of brief intervention for changing alcohol use patterns, this approach is not unique to the treatment of alcohol problems. In fact, physicians and other health care professionals widely employ this technique to help patients change a variety of behaviors (e. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.