Abstract/Summary

Background and Aims To undertake the first randomized controlled trial to evaluate the effectiveness of a brief intervention delivered by community pharmacists to reduce hazardous or harmful drinking. Design This parallel group randomized trial allocated participants individually to brief alcohol intervention (n=205) or a leaflet-only control condition (n=202), with follow-up study after 3 months. Setting Sixteen community pharmacies in one London Borough, UK. Participants A total of 407 pharmacy customers (aged 18 years or over) with Alcohol Use Disorder Identification Test (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 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 3months. 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 standardized 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% confidence interval (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.