Brief physician advice for problem drinkers: Long-term efficacy and benefit-cost analysis

Michael F. Fleming, Marlon P. Mundt, Michael French, Linda Baier Manwell, Ellyn A. Stauffacher, Kristen Lawton Barry

Research output: Contribution to journalArticle

429 Citations (Scopus)

Abstract

Background: This report describes the 48-month efficacy and benefit-cost analysis of Project TrEAT (Trial for Early Alcohol Treatment), a randomized controlled trial of brief physician advice for the treatment of problem drinking. Methods: Four hundred eighty-two men and 292 women, ages 18-65, were randomly assigned to a control (n = 382) or intervention (n = 392) group. The intervention consisted of two physician visits and two nurse follow-up phone calls. Intervention components included a review of normative drinking, patient-specific alcohol effects, a worksheet on drinking cues, drinking diary cards, and a drinking agreement in the form of a prescription. Results: Subjects in the treatment group exhibited significant reductions (p <0.01) in 7-day alcohol use, number of binge drinking episodes, and frequency of excessive drinking as compared with the control group. The effect occurred within 6 months of the intervention and was maintained over the 48-month follow-up period. The treatment sample also experienced fewer days of hospitalization (p = 0.05) and fewer emergency department visits (p = 0.08). Seven deaths occurred in the control group and three in the treatment group. The benefit-cost analysis suggests a $43,000 reduction in future health care costs for every $10,000 invested in early intervention. The benefit-cost ratio increases when including the societal benefits of fewer motor vehicle events and crimes. Conclusions: The long-term follow-up of Project TrEAT provides the first direct evidence that brief physician advice is associated with sustained reductions in alcohol use, health care utilization, motor vehicle events, and associated costs. The report suggests that a patient's personal physician can successfully treat alcohol problems and endorses the implementation of alcohol screening and brief intervention in the US health care system.

Original languageEnglish (US)
Pages (from-to)36-43
Number of pages8
JournalAlcoholism: Clinical and Experimental Research
Volume26
Issue number1
StatePublished - 2002
Externally publishedYes

Fingerprint

Cost benefit analysis
Cost-Benefit Analysis
Drinking
Alcohols
Physicians
Health care
Motor Vehicles
Therapeutics
Patient Acceptance of Health Care
Binge Drinking
Costs
Control Groups
Crime
Health Care Costs
Cues
Prescriptions
Hospital Emergency Service
Screening
Hospitalization
Randomized Controlled Trials

Keywords

  • At-Risk Drinking
  • Benefit-Cost Analysis
  • Brief Intervention
  • Primary Care
  • Problem Drinking

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Toxicology

Cite this

Fleming, M. F., Mundt, M. P., French, M., Manwell, L. B., Stauffacher, E. A., & Barry, K. L. (2002). Brief physician advice for problem drinkers: Long-term efficacy and benefit-cost analysis. Alcoholism: Clinical and Experimental Research, 26(1), 36-43.

Brief physician advice for problem drinkers : Long-term efficacy and benefit-cost analysis. / Fleming, Michael F.; Mundt, Marlon P.; French, Michael; Manwell, Linda Baier; Stauffacher, Ellyn A.; Barry, Kristen Lawton.

In: Alcoholism: Clinical and Experimental Research, Vol. 26, No. 1, 2002, p. 36-43.

Research output: Contribution to journalArticle

Fleming, MF, Mundt, MP, French, M, Manwell, LB, Stauffacher, EA & Barry, KL 2002, 'Brief physician advice for problem drinkers: Long-term efficacy and benefit-cost analysis', Alcoholism: Clinical and Experimental Research, vol. 26, no. 1, pp. 36-43.
Fleming, Michael F. ; Mundt, Marlon P. ; French, Michael ; Manwell, Linda Baier ; Stauffacher, Ellyn A. ; Barry, Kristen Lawton. / Brief physician advice for problem drinkers : Long-term efficacy and benefit-cost analysis. In: Alcoholism: Clinical and Experimental Research. 2002 ; Vol. 26, No. 1. pp. 36-43.
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