Effectiveness of a Motivational Interviewing-Based Intervention in Decreasing Risky Alcohol Use in Primary Care Patients in Spain: A Controlled Clinical Trial

Overview

Journal Healthcare (Basel)

Specialty Health Services

Date 2024 Oct 16

PMID 39408150

Authors

Celia Perula-Jimenez

Esperanza Romero-Rodriguez

Jose Angel Fernandez-Garcia

Juan Manuel Parras-Rejano

Ana Belen Carmona-Casado

Manuel Rich-Ruiz

Ana Gonzalez-De la Rubia

Juan Baleato-Gomez

The Collaborative Group Alco-Ap Study

Affiliations

Soon will be listed here.

Abstract

Objective: Our study aimed to evaluate the effectiveness of an intervention based on Motivational Interviewing (MI) performed by healthcare professionals in Primary Care (PC) patients with risky alcohol use through a multicenter, two-arm parallel, cluster-randomized, open-label controlled clinical trial.

Methods: PC professionals were randomized into two groups: an Experimental Group (EG) and a Control Group (CG). The study was carried out in PC centers of the Andalusian Health Service, located in Cordoba, Spain. An MI-based approach was implemented with patients recruited in the EG, while health advice was provided to those included in the CG. The follow-up period was 12 months, with five visits scheduled. The consumption of standard drinking units per week was quantified, and risky alcohol use was estimated using the Alcohol Use Disorders Identification Test (AUDIT). An intention-to-treat statistical analysis was performed. Relative risk (RR), absolute risk reduction (ARR) and the number of subjects needed to treat (NNT) were used to estimate the intervention effect size.

Results: A total of 268 patients were included, 148 in the EG and 120 in the CG. Considering the quantification of risky alcohol use, the ARR at 12 months after baseline visit was 16.46% (95% CI: 5.37-27.99), with an NNT of 6 (95% CI: 4-19). According to the AUDIT, the ARR at 12 months was 13.15% (95% CI: 2.73-24.24%), and the NNT was 8 (95% CI: 4-37).

Conclusions: We concluded that MI is more effective than the usual health advice in decreasing risky alcohol use in patients treated in PC.

References

Room R, Babor T, Rehm J . Alcohol and public health. Lancet. 2005; 365(9458):519-30. DOI: 10.1016/S0140-6736(05)17870-2. View

Perula-Jimenez C, Romero-Rodriguez E, Parras-Rejano J, de la Rubia A, Gomez J, Perula de Torres L . Effectiveness of a training program for the management of risky alcohol use in primary care professionals based on motivational interviewing. Aten Primaria. 2023; 56(4):102835. PMC: 10726214. DOI: 10.1016/j.aprim.2023.102835. View

. Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020. Lancet. 2022; 400(10347):185-235. PMC: 9289789. DOI: 10.1016/S0140-6736(22)00847-9. View

Varghese J, Dakhode S . Effects of Alcohol Consumption on Various Systems of the Human Body: A Systematic Review. Cureus. 2022; 14(10):e30057. PMC: 9637453. DOI: 10.7759/cureus.30057. View

Romero-Rodriguez E, Perula de Torres L, Ruiz Moral R, Fernandez Garcia J, Parras Rejano J, Roldan Villalobos A . Training health providers to address unhealthy alcohol use in primary care: a cross-sectional, multicenter study. BMC Health Serv Res. 2020; 20(1):877. PMC: 7493933. DOI: 10.1186/s12913-020-05730-4. View

Romero Rodriguez E, Perula de Torres L, Linares Ruiz A, Fernandez Garcia J, Parras Rejano J, Roldan Villalobos A . [Effectiveness of training programs on alcohol consumption in the Primary Care setting: Systematic review]. Aten Primaria. 2018; 51(9):536-547. PMC: 6945138. DOI: 10.1016/j.aprim.2018.07.004. View

Morton K, Beauchamp M, Prothero A, Joyce L, Saunders L, Spencer-Bowdage S . The effectiveness of motivational interviewing for health behaviour change in primary care settings: a systematic review. Health Psychol Rev. 2015; 9(2):205-23. DOI: 10.1080/17437199.2014.882006. View

Frost H, Campbell P, Maxwell M, OCarroll R, Dombrowski S, Williams B . Effectiveness of Motivational Interviewing on adult behaviour change in health and social care settings: A systematic review of reviews. PLoS One. 2018; 13(10):e0204890. PMC: 6193639. DOI: 10.1371/journal.pone.0204890. View

Romero-Rodriguez E, Perula-Jimenez C, Fernandez-Lopez S, Cabello-Gracia G, Fernandez-Garcia J, Perula-de Torres L . Effectiveness of a brief motivational intervention in the management of risky alcohol use in primary care: ALCO-AP20 study protocol. Front Med (Lausanne). 2023; 9:1008832. PMC: 9880185. DOI: 10.3389/fmed.2022.1008832. View

10.

Lawton B, Rose S, Elley C, Dowell A, Fenton A, Moyes S . Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial. BMJ. 2008; 337:a2509. PMC: 2769033. DOI: 10.1136/bmj.a2509. View

11.

VanBuskirk K, Wetherell J . Motivational interviewing with primary care populations: a systematic review and meta-analysis. J Behav Med. 2013; 37(4):768-80. PMC: 4118674. DOI: 10.1007/s10865-013-9527-4. View

12.

Cordoba Garcia R, Camarelles Guillem F, Munoz Seco E, Gomez Puente J, San Jose Arango J, Ramirez Manent J . . Aten Primaria. 2018; 50 Suppl 1:29-40. PMC: 6836940. DOI: 10.1016/S0212-6567(18)30361-5. View

13.

Elley C, Kerse N, Arroll B, Robinson E . Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial. BMJ. 2003; 326(7393):793. PMC: 153098. DOI: 10.1136/bmj.326.7393.793. View

14.

McCarney R, Warner J, Iliffe S, Haselen R, Griffin M, Fisher P . The Hawthorne Effect: a randomised, controlled trial. BMC Med Res Methodol. 2007; 7:30. PMC: 1936999. DOI: 10.1186/1471-2288-7-30. View

15.

DiClemente C, Corno C, Graydon M, Wiprovnick A, Knoblach D . Motivational interviewing, enhancement, and brief interventions over the last decade: A review of reviews of efficacy and effectiveness. Psychol Addict Behav. 2017; 31(8):862-887. DOI: 10.1037/adb0000318. View

16.

Campinez Navarro M, Perula de Torres L, Bosch Fontcuberta J, Barragan Brun N, Arbonies Ortiz J, Novo Rodriguez J . Measuring the quality of motivational interviewing in primary health care encounters: The development and validation of the motivational interviewing assessment scale (MIAS). Eur J Gen Pract. 2016; 22(3):182-8. DOI: 10.1080/13814788.2016.1177508. View

17.

Carroll K, Ball S, Nich C, Martino S, Frankforter T, Farentinos C . Motivational interviewing to improve treatment engagement and outcome in individuals seeking treatment for substance abuse: a multisite effectiveness study. Drug Alcohol Depend. 2005; 81(3):301-12. PMC: 2386852. DOI: 10.1016/j.drugalcdep.2005.08.002. View

18.

Polcin D, Nayak M, Korcha R, Pugh S, Witbrodt J, Salinardi M . Heavy Drinking among Women Receiving Intensive Motivational Interviewing: 6-Month Outcomes. J Psychoactive Drugs. 2019; 51(5):421-430. PMC: 6823106. DOI: 10.1080/02791072.2019.1634302. View

19.

Dutra Ponce T, Leon E, de Vargas D . Reducing women's alcohol use: a brief intervention pilot study at a primary health care service in Brazil. Women Health. 2021; 61(8):737-744. DOI: 10.1080/03630242.2021.1965692. View

20.

. [1st conference on health prevention and promotion in clinical practice in Spain. Prevention of alcohol-related problems]. Aten Primaria. 2008; 40(11):567-9. PMC: 7713474. DOI: 10.1157/13128571. View