A number of studies have indicated the potential of the primary care physician in the identification and treatment of the alcohol abuse patient. About one in five patients visiting a primary care physician presents an alcohol abuse problem. Nevertheless, the majority of family physicians do not diagnose and treat alcohol abuse. Recent studies indicate that at early stages of alcohol abuse, interventions delivered by different professionals to reduce hazardous alcohol consumption are highly effective. Brief interventions which include follow-up and biofeedback (where continuous information is provided to the patient on his/her biochemical tests) have been shown to be most successful in reducing morbidity in the alcohol abuse patient. The primary purpose of the study is to test the general hypothesis that early identification of alcohol abuse by family physicians in private practice, coupled with a brief intervention and biofeedback by a physician-nurse team significantly reduces morbidity associated with alcohol abuse. The project involves the identification of alcohol abuse by means of a non-obtrusive identification instrument acceptable to family physicians, followed by patient referral for a brief intervention by a life-style nurse. Patients are randomly assigned to different intervention groups, including a minimal intervention group. Objective outcome measures are determined at 12 and 24 months. It is hypothesized that (i) a brief behavioral self control intervention including follow-up results in superior outcome, compared with a control minimal intervention; (ii) when controlled for follow-up frequency, patients receiving biofeedback present improved outcomes compared with patients receiving no biofeedback. The study also aims at (iii) assessing the rate of identification of alcohol abuse in medical primary care and (iv) assessing the rate of successful referral to an intervention program for patients identified by physicians as at risk of alcohol abuse. The long term goal is to develop viable community models for the prevention of alcohol abuse and alcohol dependence, which staff with the family physician in private practice.
| Israel, Y; Hollander, O; Sanchez-Craig, M et al. (1996) Screening for problem drinking and counseling by the primary care physician-nurse team. Alcohol Clin Exp Res 20:1443-50 |
| Tu, G C; Israel, Y (1995) Alcohol consumption by orientals in North America is predicted largely by a single gene. Behav Genet 25:59-65 |
| Moncada, C; Torres, V; Varghese, G et al. (1994) Ethanol-derived immunoreactive species formed by free radical mechanisms. Mol Pharmacol 46:786-91 |
