Health Organization Collaborative Project on Identification and Management
of Alcohol-related Problems
Primary Health Care
of Country-wide Strategies for Implementing Early Identification and Brief Alcohol Intervention in
Primary Health Care.
Phase II of the project was a cross-national
randomised controlled trial to evaluate the effectiveness of brief alcohol
interventions in primary health care.
Ten countries (Australia, Bulgaria, Costa Rica,
Kenya, Mexico, Norway, the former Soviet Union, UK, USA and Zimbabwe) were
involved, recruiting a total of 1655 heavy (but not severely dependent) drinkers
to the study. In the core design, participants were randomly allocated to
one of three groups: a control group who received a 20 minute assessment
but no intervention; a simple advice group who received assessment
followed by 5 minutes of advice and a leaflet about sensible drinking; or a brief
counselling group who received assessment followed by 20 minutes of
For male participants, the results showed a
significant reduction in reported levels of alcohol consumption at follow-up for
both the intervention groups, with 5 minutes of simple advice being as effective
as 20 minutes of brief counselling. Participants in the intervention
groups reduced their alcohol consumption by nearly 25% compared with the control
For female participants this reduction was around
10% compared with the control group. However, there were significant
reductions in both intervention and control groups, suggesting that for women
there may be an effect from the assessment itself.
Overall, it has been estimated that around 20% of
patients identified as hazardous or harmful drinkers who receive a brief
intervention will reduce their alcohol consumption.
For more information on Phase II of the project
and the effectiveness of brief alcohol interventions, please see the references
Babor TF, Grant M. et al. A randomized
clinical trial of brief interventions in primary health care: summary of a WHO
project. Addiction. 1994; 89:657-678.
Bien TH, Miller WR, Tonigan JS. Brief
interventions for alcohol problems: A review. Addiction. 1993;
Heather N. (1995) Brief intervention
strategies. In R.K. Hester and W.R. Miller (Eds.) Handbook of
Alcoholism Treatment Approaches: Effective Alternatives (2nd Edition).
Needham heights, MA: Allyn & Bacon.
Heather N. (1998) Using brief
opportunities for change in medical settings. In W.R. Miller and N.
Heather (Eds.) Treating Addictive Behaviours (2nd Edition). New
York: Plenum Press.
World Health Organization. Project on
identification and management of alcohol-related problems. Report on phase
II: a randomized clinical trial of brief interventions in primary health care.
1992. WHO/PSA/91. WHO, Geneva.
To find out more about the other phases of the
project, please follow the links below:
[ Phase I ] [ Phase II ] [ Phase III ] [ Current research ]
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