Effectiveness of screening and ultra-brief intervention for hazardous drinking in primary care: pragmatic cluster randomised controlled trial.

Methods

Pragmatic cluster randomised controlled trial.

实用的群组随机对照试验。

40 primary care clinics in Japan that did not provide routine screening and brief intervention for hazardous drinking or treatment or self-help groups for alcohol dependency.

40家日本初级保健诊所，这些诊所不提供针对危险饮酒的常规筛查和简短干预，也不提供酒精依赖的治疗或自助小组。

1133 outpatients aged 20-74 years with hazardous drinking (AUDIT-C (alcohol use disorders identification test-consumption) scores ≥5 for men and ≥4 for women).

1133名年龄在20-74岁之间的门诊患者，存在危险饮酒行为（AUDIT-C（酒精使用障碍识别测试-消费量）评分男性≥5分，女性≥4分）。

Clinic clusters were allocated to a study arm using a computer generated random sequence.

诊所群集使用计算机生成的随机序列被分配到研究组。

Participants and staff who collected participant reported outcomes remained blinded to assignment.

收集参与者报告结果的参与者和工作人员对分配保持盲态。

Primary care clinics were randomised to ultra-brief intervention (21 clinics, 531 patients) or simplified assessment only (19 clinics, 602 patients) groups.

初级保健诊所被随机分配到超简干预组（21个诊所，531名患者）或简化评估组（19个诊所，602名患者）。

The intervention group comprised screening with AUDIT-C followed by brief oral advice and an alcohol information leaflet delivered in <1 minute.

干预组包括使用AUDIT-C进行筛查，随后进行简短的口头建议和一份在<1分钟内提供的酒精信息传单。

The control group comprised simplified assessment with AUDIT-C only.

对照组仅包括使用AUDIT-C进行的简化评估。

The primary outcome was total alcohol consumption in the four weeks preceding the 24 week follow-up.

主要结果是随访前四周内的总酒精消费量。

Secondary outcomes included total alcohol consumption in the four weeks preceding the 12 week follow-up, and readiness to change drinking behaviour, measured at 12 and 24 weeks.

次要结果包括在12周随访前四周的总酒精消耗量，以及在12周和24周测量的改变饮酒行为的准备情况。

Results

At 24 weeks, the difference in total alcohol consumption between the ultra-brief intervention group (1046.9 g/4 weeks (g/4wk), 95% confidence interval(CI) 918.3 to 1175.4) and control group (1019.0 g/4wk, 893.5 to 1144.6) was 27.8 g/4wk (-149.7 to 205.4, P=0.75), with a Hedges' g of 0.02 (95% CI -0.10 to 0.14).

在24周时，超简短干预组（1046.9克/4周（g/4wk），95%置信区间（CI）918.3至1175.4）与对照组（1019.0克/4周，893.5至1144.6）之间的总酒精消耗量差异为27.8克/4周（-149.7至205.4，P=0.75），Hedges' g为0.02（95% CI -0.10至0.14）。

At 12 weeks, the difference in total alcohol consumption between the intervention group (1034.1 g/4wk, 919.6 to 1148.7) and control group (979.3 g/4wk, 866.1 to 1092.4) was 54.9 g/4wk (-104.1 to 213.9, P=0.49), with a Hedges' g of 0.04 (-0.08 to 0.16).

在12周时，干预组（每4周1034.1克，95%置信区间919.6至1148.7）与对照组（每4周979.3克，95%置信区间866.1至1092.4）之间的总酒精消耗量差异为54.9克/4周（-104.1至213.9，P=0.49），Hedges' g为0.04（-0.08至0.16）。

Conclusions

This trial found no evidence to support the effectiveness of a doctor delivered ultra-brief intervention for hazardous drinking compared with simplified assessment only in primary care in Japan.

该试验未发现医生提供的超简短干预措施对于危险饮酒在初级保健中与仅进行简化评估相比的有效性证据。

trial_registration

UMIN Clinical Trials Registry UMIN000051388.

UMIN临床试验注册UMIN000051388。