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Alcohol question cuts misuse

GPs are being urged to routinely quiz patients about their alcohol consumption after a gold standard review established the effectiveness of brief interventions, writes Eleanor Goodman.

Brief discussions in general practice were successful at persuading patients to curb problem drinking, the Cochrane review concluded.Men who received brief interventions reduced their alcohol consumption by an average of around six standard drinks a week compared with controls.The effect of brief interventions was not statistically significant in women, although this was put down in part to the far fewer numbers included in trials. Of 7,286 participants, just 499 were women.The researchers examined data from trials where patients presented to primary care for problems unrelated to alcohol misuse. They said the findings should encourage GPs to offer interventions routinely.Dr Eileen Kaner, senior lecturer in public health at the University of Newcastle and leader of the review, said: 'GPs have built up this view that there might have been a lot of research in this area, but it didn't have meaning for them. What we are saying is that we have looked at these trials and they have been designed well, and are very applicable to primary care.'But she admitted bringing up the issue would not be easy.'GPs and nurses are very busy, and my own research shows alcohol is a difficult subject for clinicians. Alcohol consumption is something that most of us do – it's a shared behaviour.'The study also found some evidence that interventions were even more effective when given for longer periods, although this finding fell short of statistical significance.Dr Linda Harris, director of the RCGP substance and misuse unit, said GPs needed to 'take the plunge' and question their patients.'There's evidence to show that even if you just ask the question, it will sometimes stimulate a debate for someone to consider for themselves whether their drinking is excessive. 'There are leaflets that can help form a framework for consultation and help someone understand what safe drinking is.'

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