Effectiveness of screening and ultra-brief intervention for hazardous drinking in primary care: pragmatic cluster randomised controlled trial

作者：Ryuhei So, Kazuya Kariyama, Shunsuke Oyamada, Sachio Matsushita, Hiroki Nishimura, Yukio Tezuka, Takashi Sunami, Toshi A. Furukawa, Ethan Sahker, Mitsuhiko Kawaguchi, Haruhiko Kobashi, Sohji Nishina, Yuki Otsuka, Hideyuki Kanda, Yasushi Tsujimoto, Yoshinori Horie, Hitoshi Yoshiji, Takefumi Yuzuriha, Kazuhiro Nouso · 发表于：BMJ · 年份：2025 · DOI：10.1136/bmj-2024-083985 · 被引用次数：3 · 研究领域：Substance Abuse Treatment and Outcomes、Alcoholism and Thiamine Deficiency、Alcohol Consumption and Health Effects

OBJECTIVE: To evaluate the effectiveness of a doctor delivered screening and ultra-brief intervention (<1 minute) compared with simplified assessment only for reducing alcohol intake among patients with hazardous drinking in primary care. DESIGN: Pragmatic cluster randomised controlled trial. SETTING: 40 primary care clinics in Japan that did not provide routine screening and brief intervention for hazardous drinking or treatment or self-help groups for alcohol dependency. PARTICIPANTS: 1133 outpatients aged 20-74 years with hazardous drinking (AUDIT-C (alcohol use disorders identification test-consumption) scores ≥5 for men and ≥4 for women). Clinic clusters were allocated to a study arm using a computer generated random sequence. Participants and staff who collected participant reported outcomes remained blinded to assignment. INTERVENTIONS: Primary care clinics were randomised to ultra-brief intervention (21 clinics, 531 patients) or simplified assessment only (19 clinics, 602 patients) groups. The intervention group comprised screening with AUDIT-C followed by brief oral advice and an alcohol information leaflet delivered in <1 minute. The control group comprised simplified assessment with AUDIT-C only. MAIN OUTCOME MEASURES: The primary outcome was total alcohol consumption in the four weeks preceding the 24 week follow-up. Secondary outcomes included total alcohol consumption in the four weeks preceding the 12 week follow-up, and readiness to change drinking behaviour, ...