A Health Technician-delivered Brief Intervention linked to AUDIT for reduction of alcohol use in Chilean primary care: a randomized controlled trial
Open Access
- 15 June 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Addiction Science & Clinical Practice
- Vol. 16 (1), 1-10
- https://doi.org/10.1186/s13722-021-00248-4
Abstract
Background: Because of the shortage of health professionals in Chilean primary care, Health Technicians (HT) are providing Brief Interventions (BI) for risky alcohol consumption. We compared the efficacy of two AUDIT-linked interventions provided by HTs: an informative leaflet and a BI plus leaflet. Methods: This is a parallel-group randomized controlled trial with 1:1 randomization. Participants were identified through screening with the Alcohol Use Disorders Identification Test (AUDIT) at five primary care centers between March 2016 and July 2017. People older than 18 years at intermediate-risk (AUDIT score 8 to 15, inclusive) were randomized to receive either an HT-delivered BI (n = 174) or an informative leaflet (n = 168). Only data from participants (n = 294) who completed the 6-month assessment were analyzed. The leaflet was delivered without further advice. It contains alcohol consumption limits, a change planner, and strategies to decrease drinking. The BI was a 5-min discussion on the leaflet´s content plus normative feedback, tailored information on alcohol and health, and a change plan. The change in the AUDIT risk category six months after randomization (primary outcome) was compared among groups with a Chi-squared test. Changes in the secondary outcomes, which were scores on the AUDIT and the AUDIT´s consumption items (AUDIT-C), were compared with T-tests. Mixed-effects linear models adjusted for potential confounders. Outcome adjudicators were blinded to group assignment. Results: At 6-month follow-up, low-risk alcohol consumption was observed in 119 (80%) participants in the BI group, and in 103 (71%) in the leaflet group, with no difference among groups ( $$\chi 2$$ [1, N = 294] = 2.6, p = 0.1; adjusted odds ratio 0.6; 95% confidence interval [CI] 0.34, 1.05). The mean AUDIT score decreased by 5.76 points in the BI group, and by 5.07 in the leaflet group, which represents a 0.86 AUDIT point reduction attributable to the BI (secondary outcome) (T = 2.03, p = 0.043; adjusted mean difference 0.86 CI 0.06, 1.66). Conclusions: The AUDIT-linked BI delivered by HTs was not associated with a greater reduction of risky alcohol consumption than an informative leaflet. Delivering a leaflet could be more efficient than a BI when provided by HTs; however, more research on the effectiveness of the leaflet is needed. Trial registration ClinicalTrials.gov NCT02642757 (December 30, 2015) https://clinicaltrials.gov/ct2/show/NCT02642757.
Keywords
Funding Information
- FONIS (SM14I003)
This publication has 29 references indexed in Scilit:
- Can Simply Answering Research Questions Change Behaviour? Systematic Review and Meta Analyses of Brief Alcohol Intervention TrialsPLOS ONE, 2011
- Validez y confiabilidad de la versión chilena del Alcohol Use Disorders Identification Test (AUDIT)Revista médica de Chile, 2009
- Change over time in alcohol consumption in control groups in brief intervention studies: systematic review and meta-regression studyDrug and Alcohol Dependence, 2009
- Nurse-provided screening and brief intervention for risky alcohol consumption by sexual health clinic patientsSexually Transmitted Infections, 2008
- DIAL: A Telephone Brief Intervention for High-Risk Alcohol Use With Injured Emergency Department PatientsAnnals of Emergency Medicine, 2008
- Assessment may conceal therapeutic benefit: findings from a randomized controlled trial for hazardous drinkingAddiction, 2006
- Evaluation of a Brief Intervention in an Inner-City Emergency DepartmentAnnals of Emergency Medicine, 2005
- Effectiveness of a brief-intervention and continuity of care in enhancing attendance for treatment by adolescent substance usersDrug and Alcohol Dependence, 2004
- Phases of Alcohol Problem Prevention ResearchAlcohol: Clinical and Experimental Research, 1999
- Screening for Problem Drinking and Counseling by the Primary Care Physician‐Nurse TeamAlcohol: Clinical and Experimental Research, 1996