Brief interventions for high-risk drinkers.

AIMS AND
OBJECTIVES: The purpose of this paper is to explore the literature on brief alcohol intervention and to review the literature that examines the status of the clinic nurse in the delivery of these interventions. The objective is to review critically the literature on brief intervention to create links for nurse developed and delivered brief intervention to high-risk drinkers.
BACKGROUND: Population estimates suggest that more than one-third of North Americans drink excessively with even higher rates for individuals treated in primary care settings. Alcohol use has been identified as the third leading cause of mortality in the United States. This problem is not unique to the US and, worldwide, agencies and governmental offices and ministries have issued recommendations to screen patients for alcohol misuse and deliver brief interventions to individuals considered to be high-risk drinkers. Numerous randomized controlled trials and recent meta-analyses have supported the use of screening and brief intervention for reducing alcohol consumption in primary healthcare settings. The vast majority of studies reporting on brief interventions have focused on the role of the physician with minimal if any involvement of the clinic nurse. A scant number of studies have been conducted that define and assess the role or potential role of the clinic nurse in providing screening and brief intervention to high-risk drinkers in the primary care setting.
METHODS: Systematic review.
RESULTS: Six systematic reviews and meta-analyses from an international base of studies support the use of brief intervention in the primary care setting. Three randomized control trials have highlighted the role of the staff or clinic nurse but there are no meta-analyses addressing nurse-delivered brief interventions. Numerous studies have explored factors effecting the implementation of brief intervention into the primary care setting.
CONCLUSION: Brief intervention is recognized as a legitimate nursing role but little has been done to develop and define the role of the nurse in delivering brief interventions to high-risk drinkers. This represents a major lacuna in both the nursing and alcoholism literature, where only a handful of studies have investigated nurse-delivered brief intervention. RELEVANCE TO CLINICAL PRACTICE: As health screening and health promotion are hallmarks of nursing care, nurses need to explore the use of brief intervention in their daily practice.