Ranjita Dhital1, Ian Norman1, Cate Whittlesea2, Trevor Murrells1, Jim McCambridge3. 1. King's College London, Florence Nightingale Faculty of Nursing and Midwifery, London, UK. 2. School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK. 3. Mental Health and Addictions Research Group, Department of Health Sciences, Faculty of Science, University of York, York, UK.
Abstract
BACKGROUND AND AIMS: To undertake the first randomized controlled trial to evaluate the effectiveness of a brief intervention delivered by community pharmacists to reduce hazardous or harmful drinking. DESIGN: This parallel group randomized trial allocated participants individually to brief alcohol intervention (n = 205) or a leaflet-only control condition (n = 202), with follow-up study after 3 months. SETTING:Sixteen community pharmacies in one London Borough, UK. PARTICIPANTS: A total of 407 pharmacy customers (aged 18 years or over) with Alcohol Use Disorder Identification Test (AUDIT) scores 8-19, inclusive. INTERVENTION: A brief motivational discussion of approximately 10 minutes' duration, for which 17 pharmacists received a half-day of training. MEASUREMENTS: Hazardous or harmful drinking was assessed using the AUDIT administered by telephone by a researcher blind to allocation status. The two primary outcomes were: (1) change in AUDIT total scores and (2) the proportions no longer hazardous or harmful drinkers (scoring < 8) at 3 months. The four secondary outcomes were: the three subscale scores of the AUDIT (for consumption, problems and dependence) and health status according to the EQ-5D (a standardized instrument for use as a measure of health outcome). FINDINGS: At 3 months 326 (80% overall; 82% intervention, 78% control) participants were followed-up. The difference in reduction in total AUDIT score (intervention minus control) was -0.57, 95% confidence interval (CI) = -1.59 to 0.45, P = 0.28. The odds ratio for AUDIT ˂ 8 (control as reference) was 0.87, 95% CI = 0.50 to 1.51, P = 0.61). For two of the four secondary outcomes (dependence score: -0.46, 95% CI = -0.82 to -0.09, P = 0.014; health status score: -0.09, 95% CI = -0.16 to -0.02, P = 0.013) the control group did better, and in the other two there were no differences (consumption score: -0.05, 95% CI = -0.54 to 0.44, P = 0.85; non-dependence problems score: -0.13, 95% CI = -0.66 to 0.41). Sensitivity analyses did not change these findings. CONCLUSIONS: A brief intervention delivered by community pharmacists appears to have had no effect in reducing hazardous or harmful alcohol consumption.
RCT Entities:
BACKGROUND AND AIMS: To undertake the first randomized controlled trial to evaluate the effectiveness of a brief intervention delivered by community pharmacists to reduce hazardous or harmful drinking. DESIGN: This parallel group randomized trial allocated participants individually to brief alcohol intervention (n = 205) or a leaflet-only control condition (n = 202), with follow-up study after 3 months. SETTING: Sixteen community pharmacies in one London Borough, UK. PARTICIPANTS: A total of 407 pharmacy customers (aged 18 years or over) with Alcohol Use Disorder Identification Test (AUDIT) scores 8-19, inclusive. INTERVENTION: A brief motivational discussion of approximately 10 minutes' duration, for which 17 pharmacists received a half-day of training. MEASUREMENTS: Hazardous or harmful drinking was assessed using the AUDIT administered by telephone by a researcher blind to allocation status. The two primary outcomes were: (1) change in AUDIT total scores and (2) the proportions no longer hazardous or harmful drinkers (scoring < 8) at 3 months. The four secondary outcomes were: the three subscale scores of the AUDIT (for consumption, problems and dependence) and health status according to the EQ-5D (a standardized instrument for use as a measure of health outcome). FINDINGS: At 3 months 326 (80% overall; 82% intervention, 78% control) participants were followed-up. The difference in reduction in total AUDIT score (intervention minus control) was -0.57, 95% confidence interval (CI) = -1.59 to 0.45, P = 0.28. The odds ratio for AUDIT ˂ 8 (control as reference) was 0.87, 95% CI = 0.50 to 1.51, P = 0.61). For two of the four secondary outcomes (dependence score: -0.46, 95% CI = -0.82 to -0.09, P = 0.014; health status score: -0.09, 95% CI = -0.16 to -0.02, P = 0.013) the control group did better, and in the other two there were no differences (consumption score: -0.05, 95% CI = -0.54 to 0.44, P = 0.85; non-dependence problems score: -0.13, 95% CI = -0.66 to 0.41). Sensitivity analyses did not change these findings. CONCLUSIONS: A brief intervention delivered by community pharmacists appears to have had no effect in reducing hazardous or harmful alcohol consumption.
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