Evidence
This section contains a brief overview of the research carried out in this area. The evidence is divided into the settings listed here.
View overview
The response to alcohol related harm needs to move from the traditional and exclusive focus on “alcoholics”—that is, those with severe alcohol dependence and problems. 1 It should include brief interventions among hazardous and harmful drinkers identified in a range of generalist settings.
In the adult (16-64 years) population of England, an estimated 32% of men and 15% of women (23% overall) are hazardous or harmful drinkers, with consumption consistently over recommended weekly limits (21 standard alcohol units for men and 14 for women). 2 This equates to 7.1 million people. An estimated 21% of men and 9% of women are binge drinkers, with consumption on one occasion in the past week over twice the recommended daily limits (8 units for men and 6 for women). There is considerable overlap between men and women drinking amounts above the daily and weekly benchmarks.
References
- Raistrick D, Heather N, Godfrey C. Review of the effectiveness of treatment for alcohol problems. London: National Treatment Agency for Substance Misuse, 2006. External Link
- Drummond C, Oyesfeso A, Phillips T, Cheeta S, Deluca P, Perryman K, et al. Alcohol needs assessment research project (ANARP). London: Department of Health, 2005. Interventions effective for secondary prevention of alcohol problems
Interventions effective for secondary prevention of alcohol problems
View Methodology
Topics searched
We searched for studies on secondary prevention of alcohol misuse in people of all ages. The studies were based in the following settings: educational establishments (that is, schools or universities), hospitals, primary care, workplace, and community.
Studies that had only self reported outcomes, that were unvalidated by another person, were excluded from the review by critical appraisal.
Dates and study types searched
We searched for systematic reviews published from 1990 until September 2006 and randomised controlled trials published from 2001 until September 2006.
Databases searched
We searched Medline, Embase, PsycInfo, and the Cochrane Library for relevant studies. We also searched the Cork database, Trip database, Health evidence.ca, and the WHO Health Evidence Network (HEN).
Search strategy
These are searches that have been conducted on Ovid Medline (http://gateway.ovid.com/). The other searches have been adapted from this one to accommodate the search engine of each specific database.
Alcohol misuse, secondary prevention
1. ((problem or heavy or chronic) adj2 drinker$).ti,ab.
2. ((hazardous or harmful or problem) adj2 drinking).ti,ab.
3. prevent$.ti,ab.
4. early intervention$.ti,ab.
5. (motivational interview$ or brief intervention$ or brief treatment$).ti,ab.
6. referral$.ti,ab.
7. (early adj2 (treatment$ or therap$)).ti,ab.
8. early intervention/
9. Alcoholism/pc, th [Prevention & Control, Therapy]
10. (inpatient$ or residen$ or hospitaliz$ or hospitalis$).ti.
11. or/1-2
12. or/3-8
13. 11 and 12 and 9
14. 13 not 10
Filter
The following filter was used to include only randomised controlled trials or systematic reviews:
1. ("review" or "review academic" or "review tutorial").pt.
2. (medline or medlars or embase).tw,sh
3. (scisearch or psychinfo or psycinfo).tw,sh.
4. (psychlit or psyclit).tw,sh.
5. cinahl.tw,sh.
6. ((hand adj2 search$) or (manual$ adj2 search$)).tw,sh.
7. (electronic database$ or bibliographic database$ or computeri?ed database$ or online database$).tw,sh
8. (pooling or pooled or mantel haenszel).tw,sh.
9. (peto or dersimonian or der simonian or fixed effect).tw,sh.
10. or/2-9 47239
11. 1 and 10
12. meta-analysis.pt.
13. meta-analysis.sh.
14. (meta-analys$ or meta analys$ or metaanalys$).tw,sh.
15. (systematic$ adj5 review$).tw,sh.
16. (systematic$ adj5 overview$).tw,sh.
17. (quantitativ$ adj5 review$).tw,sh.
18. (quantitativ$ adj5 overview$).tw,sh.
19. (quantitativ$ adj5 synthesis$).tw,sh
20. (methodologic$ adj5 review$).tw,sh.
21. (methodologic$ adj5 overview$).tw,sh.
22. (integrative research review$ or research integration).tw.
23. or/12-22
24. 11 or 23
25. exp Randomized controlled trials/
26. "randomized controlled trial".pt.
27. "controlled clinical trial".pt.
28. (random$ or placebo$).ti,ab,sh.
29. ((singl$ or double$ or triple$ or treble$) and (blind$ or mask$)).tw,sh.
30. or/25-29
31. (animals not humans).sh.
32. 30 not 31
What are the effects of interventions for primary prevention of alcohol misuse?
View Methodology
Topics searched
We searched for studies on primary prevention of alcohol misuse in people of all ages. The studies were based in the following settings: schools, community and families.
Studies that had only self reported outcomes, that were unvalidated by another person, were excluded from the review by critical appraisal.
Dates and study types searched
We searched for systematic reviews published from 1990 until 2006 and randomised controlled trials published from 2001 until 2006.
Databases searched
We searched Medline, Embase, PsycInfo, and the Cochrane Library for relevant studies. We also searched the Cork database, Trip database, Health evidence.ca, and the WHO Health Evidence Network (HEN).
Search strategy
These are searches that have been conducted on Ovid Medline (http://gateway.ovid.com/). The other searches have been adapted from this one to accommodate the search engine of each specific database.
Alcohol misuse, primary prevention
The following filter was used to include articles on primary alcohol prevention
33 exp ALCOHOLISM/
34 exp drinking behavior/
35 Temperance/
36 exp Alcoholic Beverages/
37 Alcoholic Intoxication/
38 ((hazardous or harmful or problem) adj2 drinking).ti,ab.
39 ((misus$ or abus$ or consum$) adj2 alcohol$).ti,ab.
40 (liquor or beer$ or wine$).ti,ab.
41 prevent$.ti,ab.
42 pc.fs.
43 prophyla$.ti,ab.
44 Government Regulation/
45 (policy or policies).ti,ab.
46 Legislation/
47 (educat$ or counsel$ or promot$ or program$ or campaign$ or intervention$).ti,ab.
48 ((control$ or reduc$ or decreas$) adj2 (alcohol$ or drinking)).ti,ab.
49 or/41-43,48
50 or/44-47
51 or/33-40
52 49 and 50
53 51 and 52
54 32 and 53 (NB ‘32’ refers to the RCT filter search results)
55 limit 54 to yr="2001 - 2006"
56 (withdraw$ or dependen$ or detox$ or relaps$).ti.
57 55 not 56
Filter
The following filter was used to include only randomised controlled trials or systematic reviews:
1. ("review" or "review academic" or "review tutorial").pt.
2. (medline or medlars or embase).tw,sh
3. (scisearch or psychinfo or psycinfo).tw,sh.
4. (psychlit or psyclit).tw,sh.
5. cinahl.tw,sh.
6. ((hand adj2 search$) or (manual$ adj2 search$)).tw,sh.
7. (electronic database$ or bibliographic database$ or computeri?ed database$ or online database$).tw,sh
8. (pooling or pooled or mantel haenszel).tw,sh.
9. (peto or dersimonian or der simonian or fixed effect).tw,sh.
10. or/2-9 47239
11. 1 and 10
12. meta-analysis.pt.
13. meta-analysis.sh.
14. (meta-analys$ or meta analys$ or metaanalys$).tw,sh.
15. (systematic$ adj5 review$).tw,sh.
16. (systematic$ adj5 overview$).tw,sh.
17. (quantitativ$ adj5 review$).tw,sh.
18. (quantitativ$ adj5 overview$).tw,sh.
19. (quantitativ$ adj5 synthesis$).tw,sh
20. (methodologic$ adj5 review$).tw,sh.
21. (methodologic$ adj5 overview$).tw,sh.
22. (integrative research review$ or research integration).tw.
23. or/12-22
24. 11 or 23
25. exp Randomized controlled trials/
26. "randomized controlled trial".pt.
27. "controlled clinical trial".pt.
28. (random$ or placebo$).ti,ab,sh.
29. ((singl$ or double$ or triple$ or treble$) and (blind$ or mask$)).tw,sh.
30. or/25-29
31. (animals not humans).sh.
32. 30 not 31