Abstract

Objectives: To evaluate the short term effects of screening and brief advice to reduce unhealthy alcohol use in primary care setting and to evaluate the role of patient’s motivation.

Background: Alcohol consumption in the Czech Republic is among the highest in the EU. Screening and brief advice in primary health care may reduce alcohol use related harms.

Materials and methods: 161 patients (61% were males) of 699 were identified as hazardous or harmful drinkers in ten offices of general practitioners using the ASSIST v.3 and AUDIT-C screening tests. Patients were assigned into two groups: in group 1 personalised advice was provided by general practitioner) and in group 2 printed self-help materials were distributed. The baseline mean weekly alcohol consumption calculated via beverage specific quantity frequency method has been compared with weekly consumption after 3 months. During the follow-up interview, patients were asked about their motivations for changing their drinking behaviour.

Results The results showed that in the group 1 (personalized advice) there was a statistically significant decrease in the mean alcohol consumption from 279.4 grams of alcohol per week to 174.0 grams (t = 4.02; df = 84; p = 0.000). Total alcohol consumption also slightly decreased in the intervention group 2 (self-help materials) from 170.7 to 160.3 grams per week, but the difference in means did not reach statistical significance (t = 0.54; df = 37; p = 0.59). In group 1 among patients motivated to change their drinking behaviour we found impressive decrease in volume of alcohol intake (from 310.2 g to 139.0 g weekly – t = 4.56; df =  49; p = .000), however among non-motivated patients no change in consumption was registered (227.4 at baseline and 234.7 after 3 months; t = 0.33; df = 32; p = 0.75). Personal motivation had no impact on consumption in group 2.

Conclusions The results suggest that personalized advice of GP and patient’s positive motivation for change led to marked reduction in alcohol consumption. Brief advice implemented in primary care is effective and may be together with motivation enhancement recommended for implementation into primary health care.