The effectiveness of brief alcohol interventions delivered by community pharmacists: randomised controlled trial

Abstract

Background & Aims: To undertake the first randomised controlled trial to evaluate the effectiveness of a brief intervention delivered by community pharmacists to reduce hazardous or harmful drinking. Design: This parallel group individually randomised trial, allocated participants to brief alcohol intervention (n=205) or a leaflet-only control condition (n=202), with follow-up study after 3 months. Setting: 16 community pharmacies in one London borough, UK. Participants: 407 pharmacy customers (aged 18 or over) with AUDIT scores 8-19 inclusive. Intervention: A brief motivational discussion of approximately 10 minutes duration for which 17 pharmacists received a half-day of training. Measurements: Hazardous or harmful drinking was assessed using the Alcohol Use Disorders Identification Test (AUDIT) administered by telephone by a researcher blind to allocation status. The two primary outcomes were: 1) change in AUDIT total scores and 2) the proportions no longer hazardous or harmful drinkers (scoring <8) at three months. The four secondary outcomes were: the three subscale scores of the AUDIT (for consumption, problems and dependence), and health status according to the EQ-5D (a standardised instrument for use as a measure of health outcome). Findings: At 3 months 326 (80% overall; 82% intervention, 78% control) participants were followed up. The difference in reduction in total AUDIT score (intervention minus control) was -0.57 95% CI -1.59 to 0.45, p = 0.28. The odds ratio for AUDIT < 8 (control as reference) was 0.87 95% CI 0.50 to 1.51, p = 0.61). For two of the four secondary outcomes (dependence score: -0.46 95% CI -0.82 to -0.09, p = 0.014; health status score: -0.09 95% CI -0.16 to -0.02, p = 0.013) the control group did better, and in the other two there were no differences (consumption score: -0.05 95% CI -0.54 to 0.44, p = 0.85; non-dependence problems score: -0.13 95% CI -0.66 to 0.41). Sensitivity analyses did not change these findings. Conclusions: A brief intervention delivered by community pharmacists appears to have had no effect in reducing hazardous or harmful alcohol consumption.