Efficiency of brief interventions on alcohol-related risks in occupational medicine

Abstract

Aim . To evaluate the effectiveness of brief interventions (BIs) in reducing alcohol use among hazardous drinkers consulting their occupational doctors. Materials and methods . Design: Randomized controlled trial with 12-month follow-up, conducted between November 2004 and September 2006. Setting: Fifteen French regional occupational medicine centers with 147 doctors and 157 assistants who were trained in BI and screening with the AUDIT questionnaire. Participants: We invited 33,488 individuals to fill out AUDIT. These patients were eligible if their scores were 6–12 for women and 7–12 for men, indicating hazardous drinking without dependence (found in 7.1% of respondents). Intervention: After randomization, BIs (informative advice using motivational approach, with 10-minute average duration) were performed by the occupational doctors. The control group received information booklets from the doctors’ assistants. Measurements: Situations were evaluated 12 months after inclusion. Outcome measures: AUDIT scores, self-reported alcohol consumption (SRAC) and biological assays. The main criteria were the differences observed between groups for SRAC, the AUDIT score at follow-up, and any reduction in score between inclusion and final assessment. Success of intervention, which was defined as an AUDIT score below the hazardous drinking threshold at follow-up, was considered to analyze the variables associated with the efficiency of intervention. Results . The analyzed sample included 787 persons, among whom 435 were met again 12 months later. In the BI group, we found a lower AUDIT score (p = 0.01), a higher reduction in reported consumptions (–60 g/week versus −44g/week, p = 0.04) and in AUDIT scores (p = 0.009). In the control group, 44.8% reduced their AUDIT scores below hazardous drinking thresholds, as compared to 51.6% in the BI group (p = 0.15). Success was associated with a significant reduction in biological and clinical indices. Conclusions . Though the high attrition rate led to careful conclusions, BIs seem to be efficient in occupational medicine, in comparison with written information, which also seems to influence drinking behavior.