The effectiveness of brief alcohol interventions delivered by community pharmacists: randomized controlled trial


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Abstract

Background and AimsTo undertake the first randomized controlled trial to evaluate the effectiveness of a brief intervention delivered by community pharmacists to reduce hazardous or harmful drinking.DesignThis 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.SettingSixteen community pharmacies in one London Borough, UK.ParticipantsA total of 407 pharmacy customers (aged 18 years or over) with Alcohol Use Disorder Identification Test (AUDIT) scores 8–19, inclusive.InterventionA brief motivational discussion of approximately 10 minutes' duration, for which 17 pharmacists received a half-day of training.MeasurementsHazardous 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).FindingsAt 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.ConclusionsA brief intervention delivered by community pharmacists appears to have had no effect in reducing hazardous or harmful alcohol consumption.

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