Evidence map›Paper›PMID 26083959›Full record

Trial reportJournal of addiction medicine

Brief Intervention for Heavy Drinking in Primary Care: Role of Patient Initiation.

Gail L Rose, Sarah E Guth, Gary J Badger, Dennis A Plante, Tera L Fazzino, John E Helzer

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of addiction medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Gail L RoseDepartment of Psychiatry (GLR, SEG, JEH), Department of Medical Biostatistics (GJB), and Department of General Internal Medicine (DAP), University of Vermont, College of Medicine, Burlington, VT; and Department of Preventive Medicine and Public Health (TLF), University of Kansas School of Medicine, Kansas City, KS.
Sarah E Guth
Gary J Badger
Dennis A Plante
Tera L Fazzino
John E Helzer

Funding

Automated Alcohol Screening and Brief Intervention in Primary Care Using IVRR01AA018658 · NIAAA · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI ROSE, GAIL LYNNE · 2010 to 2014
$3.0M
Therapeutic IVR to Augment CBT in Alcohol Dependence.R01AA014270 · NIAAA · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI HELZER, JOHN E · 2004 to 2008
$2.5M
ENHANCING BRIEF INTERVENTION OF PRIMARY CARE PHYSICIANSR01AA011954 · NIAAA · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI HELZER, JOHN E · 1999 to 2003
$2.1M
IVR for Automated Alcohol Screening & BI in Primary CareR21AA015777 · NIAAA · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI HELZER, JOHN E · 2006 to 2007
$326k
NIAAA NIH HHS R01 AA011954NIAAA NIH HHS R01 AA014270NIAAA NIH HHS R01 AA018658NIAAA NIH HHS R01AA018658NIAAA NIH HHS R01AA11954NIAAA NIH HHS R21 AA015777
6 · The paper itself

Abstract

backgroundAlcohol brief intervention (BI) in primary care (PC) is effective, but remains underutilized despite multiple efforts to increase provider-initiated BI. An alternative approach to promote BI is to prompt patients to initiate alcohol-related discussions. Little is known about the role of patients in BI delivery.

objectivesTo determine the characteristics of PC patients who reported initiating BI with their providers, and to evaluate the association between the initiator (patient vs provider) and drinking after a BI.

methodsIn the context of clinical trial, patients (n = 267) who received BI during a PC visit reported on the manner in which the BI was initiated, readiness to change, demographics, and recent history of alcohol consumption. Drinking was assessed again at 6-months after the BI.

resultsFifty percent of patients receiving a BI reported initiating the discussion of drinking themselves. Compared with those who reported a provider-initiated discussion, self-initiators were significantly younger (43.7 years vs 47.1 years; P = 0.03), more likely to meet Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for current major depression (24% vs 14%; P = 0.04), and more likely to report a history of alcohol withdrawal symptoms (68% vs 52%; P < 0.01). Baseline readiness to change, baseline consumption rates, and current DSM-IV alcohol dependence were not different between groups. In the 2 to 3 weeks after BI, self-initiators reported greater decreases in drinks per week (5.7 vs 2.4; P = 0.02), and drinking days per week (1.0 vs 0.3; P = 0.002). At 6-month follow-up, self-initiators showed significantly greater reductions in weekly drinking compared to those whose provider initiated the BI (P = 0.002).

conclusionsPatient- and provider-initiated BI occurred with equal frequency, and patient-initiated BIs were associated with greater reductions in alcohol use. Future efforts to increase the BI rate in PC should include a focus on prompting patients to initiate alcohol-related discussions.

Indexed as

Self CareAdultAlcohol DrinkingFemaleHumansMaleMiddle AgedPrimary Health CarePsychotherapy, BriefYoung Adult

Identifiers

PMID26083959
PMCPMC4592373

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.