The goal of this research is to test the efficacy of brief physician advice in reducing alcohol use, health care utilization, and in improving health status in problem drinkers in Polish primary care clinics. Although evidence exists - both internationally and in the United States - to support the conclusion that brief physician advice can decrease alcohol use, additional research is needed to support implementation of brief intervention treatment in the new health care system of Poland and eastern Europe. Alcohol use is an enormous health and social problem in Poland. Rates of alcohol-related problems such as cirrhosis, stroke, and accidents,are among the highest in the world. Primary care physicians, a new and essential component of the completely re-focused Polish health care system, are in an opportune situation to identify and treat the majority of people adversely affected by alcohol. The proposed trial is a joint project between the University of Wisconsin Center for Addiction Research and Education (CARE) and the Policy Institute of Psychiatry and Neurology. The trial is designed to replicate a successful brief intervention trial (Project TrEAT) conducted in the U.S. health care system. Project TrEAT, an NIAAA-funded R-01 trial, was conducted by the Principal Investigator in the offices of 64 primary care physicians in southern Wisconsin. For the past 15 months, the PI has been working with Poland to develop a nationwide faculty development program focused on the prevention and treatment of alcohol use disorders. The proposed trial defines problem drinkers as men who consume 3 or more drinks/day or 21 drinks/week, or women who drink 2 or more drinks/day or 14 or more drinks/week in the 7 days prior to the research interview. These subjects will be recruited from the practices of 20 primary care physicians in Lodz, Katowice, and Warzsawa, Poland. The intervention will consist of a structured brief advice protocol administered by the subject's primary care physician. The 20 physician interventionists will participate in a skills training workshop and periodic booster sessions to standardize the intervention. The effect of the intervention will be assessed by examining changes in alcohol-related behaviors and health status over a six month period. Changes will be assessed utilizing patient self-report, family member interview, and medical record review. This project will be the first large-scale randomized clinical trial conducted in Poland to test the effect of brief physician advice with problem drinkers. The study uniquely addresses the important research area of alcohol abuse and would significantly add to our understanding of the efficacy of physician intervention in the secondary prevention of alcohol problems in Poland and Eastern Europe.
| Manwell, Linda Baier; Czabala, Jan Czeslaw; Ignaczak, Marek et al. (2004) Correlates of depression among heavy drinkers in Polish primary care clinics. Int J Psychiatry Med 34:165-78 |
| Manwell, Linda Baier; Ignaczak, Marek; Czabala, Jan C (2002) Prevalence of tobacco and alcohol use disorders in Polish primary care settings. Eur J Public Health 12:139-44 |
