The Value of Brief Physician Interventions
Source: Kaner EFS, et al. Effectiveness of brief alcohol interventions in primary care populations (Review). The Cochrane Database of Systematic Reviews 2007, Issue 2.
As is often the case, this chief virtue of this Cochrane Review is its authoritative confirmation of a concept already verified by several studies.
After reviewing 21 randomized controlled trials with 7,286 participants, Eileen Kaner, the lead author, summarized the findings thusly:
More specifically, the results indicated that a single, brief intervention, typically as short as five minutes, decreased alcohol intake by an average of four drinks per week.
The target group consisted of patients who were heavy drinkers but not alcoholics.
Commentary
While the Cochrane Review dealt with alcohol use, parallel studies (although not a Cochrane Review) have demonstrated that brief interventions can have positive effects on smoking.
My clinical stance, equally influenced by cynicism and pragmatism, has been that, given the catastrophic risks of smoking and excessive drinking and the brief amount of time required for such an intervention, even a success rate as small as, say, 5% justified, if not mandated, that these issues be addressed in the office. This Cochrane Review reaffirms that notion.
One result of patient compliance is rendering treatment outcome somewhat of a numbers game. Just as more sales calls result in more sales and more at-bats result in more base hits (assuming the participants are competent), the more patients to whom a clinician recommends a decrease in drinking or a cessation of tobacco use, the more successful clinical outcomes.
And, we now know that those recommendations can be made efficiently without sacrificing effectiveness.