McIntosh M C, Leigh G, Baldwin N J, Marmulak J
Sydney Family Practice Centre, NS.
Can Fam Physician. 1997 Nov;43:1959-62, 1965-7.
To compare the effects of three brief methods of reducing alcohol consumption among family practice patients.
Patients randomly assigned to one of three interventions were assessed initially and at 3-, 6-, and 12-month follow-up appointments.
Family practice clinic composed of 12 primary care physicians seeing approximately 6000 adults monthly in a small urban community, population 40,000.
Through a screening questionnaire, 134 men and 131 women were identified as hazardous drinkers (five or more drinks at least once monthly) during an 11-month screening of 1420 patients. Of 265 patients approached, 180 agreed to participate and 159 (83 men and 76 women) actually participated in the study.
Three interventions were studied: brief physician advice (5 minutes), two 30-minute sessions with a physician using cognitive behavioural strategies or two 30-minute sessions with a nurse practitioner using identical strategies.
Quantity and frequency (QF) of drinking were used to assess reduction in hazardous drinking and problems related to drinking over 12 months of follow up.
No statistical difference between groups was found. The QF of monthly drinking was reduced overall by 66% (among men) and 74% (among women) for those reporting at least one hazardous drinking day weekly at assessment (N = 96). Men reported drinking significantly more than women.
These results indicated that offering brief, specific advice can motivate patients to reduce their alcohol intake. There was no difference in effect between brief advice from their own physician or brief intervention by a physician or a nurse.
比较三种简短方法对家庭医疗患者减少饮酒量的效果。
将患者随机分配至三种干预措施之一，在初始阶段以及3个月、6个月和12个月的随访预约时进行评估。
家庭医疗诊所，由12名初级保健医生组成，每月在一个人口为40000的小型城市社区为约6000名成年人看病。
在对1420名患者进行的为期11个月的筛查中，通过筛查问卷，有134名男性和131名女性被确定为危险饮酒者（每月至少有一次饮用五杯或更多酒）。在接触的265名患者中，180名同意参与，159名（83名男性和76名女性）实际参与了研究。
研究了三种干预措施：医生简短建议（5分钟）、与医生进行两次30分钟使用认知行为策略的疗程或与执业护士进行两次30分钟使用相同策略的疗程。
饮酒量和饮酒频率（QF）用于评估在12个月的随访中危险饮酒量的减少以及与饮酒相关的问题。
未发现组间存在统计学差异。对于在评估时每周至少有一天危险饮酒的人（N = 96），每月饮酒的QF总体上男性降低了66%，女性降低了74%。男性报告的饮酒量显著多于女性。
这些结果表明，提供简短、具体的建议可以促使患者减少酒精摄入量。来自患者自己医生的简短建议与医生或护士的简短干预在效果上没有差异。
