The Cochrane Collaboration review selected 69 studies, including 33,642 individuals. 55% of the studies were conducted in PC, while others were in hospital emergencies and other settings. 88% compare IB with minimal or no intervention. The average result was a 20g/week decrease after one year. A great heterogeneity of the studies was observed due to the difficulties of obtaining a reliable quantification over time of alcohol consumption. For this reason, it is difficult to propose meta-analyses, which are rather systematic reviews with a wide range of results. Among other results, he observed a generally non-significant decrease in episodes of habitual intensive consumption, a lower number of days of consumption per week, and a decrease in the intensity of consumption.
The study on the efficacy of medical advice to reduce consumption in Spain revealed a decrease in about 100 g of alcohol per week (6.5–13.8g/ day) after one year of follow-up 22. On the other hand, the Spanish studies revealed a reduction in the percentage of risk drinkers submitted to the intervention group, indicating a modest but real qualitative change in the transition from the risk group to the low-risk group. The USPSTF recommends BI in the adult population over 18 years of age, although it does not consider the effectiveness of BI in adolescents between 12 and 18 years to be proven 23. The semFYC Preventive Activities Program (PAPPS) also makes these recommendations
Implementation Of Screening And Brief Intervention
Implementation of screening and brief intervention remains quite low, despite the high prevalence of risky drinking, its association with mortality and disability, and the evidence of the effectiveness of screening and BI. For example, in the United States, only 1 in 6 patients report discussing alcohol with their doctor; rates in Europe are equally low 25. Even when screening is performed, validated questionnaires are used infrequently. Reasons for their low acceptance may include challenges related to implementation and clinicians’ perceptions of their roles. Brief interventions are unlikely to cause harm (unless poorly delivered or confidentiality is breached), and the consequences of risky alcohol use can be severe. Even small changes by decreasing alcohol consumption could improve health outcomes at the population level. Another reason for low BI implementation is that the components of brief behavioral counseling interventions are not standardized in content, delivery, dose, or duration. Besides, patients assessed and counseled about alcohol use report receiving high-quality primary care.
Brief Intervention In A Risk Drinker From Primary Health Care
To analyze the clinical case of a risk drinker from the perspective of primary health care and the use of the brief intervention in said patient. Material and methods: The clinical case of a 52-year-old male patient who attends the primary care clinic for stomach ailments is studied. Medical history is collected, including eating habits and substance use; analytical tests are requested. The clinical history, the physical examination, and the analytical evaluation indicate a gastric pathology and high-risk alcohol consumption. For this reason, a brief intervention is carried out to promote a change in the consumption of identified risks. In the primary care consultation, it would be advisable to carry out a systematic screening of alcohol consumption and administer a brief intervention (assessment, advice or advice, and some follow-up) to patients identified as drinkers with risk or harmful consumption of alcohol.