Physician Advice for Problem Drinkers

Project TrEAT (trial for early Alcohol Treatment) is the first large U.S. clinical trial conducted by primary care practitioners to elucidate the effect of brief physician advice in reducing alcohol use by problem drinkers.

The intervention consisted of a workbook that contained feedback regarding current health behaviors, a review of prevalence of and consequences of problem drinking, a worksheet on drinking cues, a drinking agreement (in the form of a prescription), and drinking diary cards. These were administered to 392 problem drinkers identified by screening a population of 17,695 patients. Interventions were done two times for 15 minutes, with two clinic nurse phone call follow-ups.

Reduction in alcohol use was substantial, reaching almost 50% among women in the experimental group. On average, men in the experimental group reduced their alcohol consumption by eight drinks per week, and binge drinking declined 44%. Trials in Sweden, Great Britain, and multinational trials by the World Health Organization have found significant alcohol use reductions (including decreases in GGTP and health care use over up to 5 years post-intervention) resulting from brief interventions.

Brief advice protocols can significantly change problem drinking behavior and may be successfully employed in community primary care practices.

Fleming M, et al. JAMA 1997;277: 1039-1045.