Search tips
Search criteria 


Logo of bmjThe BMJ
BMJ. 1988 September 10; 297(6649): 663–668.
PMCID: PMC1834369

Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption.


OBJECTIVE: To determine effectiveness of advice from general practitioners to heavy drinkers to reduce their excessive alcohol consumption (35 U or more a week for men, 21 U or more for women). DESIGN: Randomised, controlled double blind trial over 12 months with interim assessment at six months. SETTING: Group practices (n = 47; list size averaging 10,000) recruited from Medical Research Council's general practice research framework, mostly in rural or small urban settings. PATIENTS: Patients recruited after questionnaire survey. Of total of 2571 (61.2%) of 4203 patients invited for interview who attended, 909 (35.4%) stated that in past seven days they had drunk above the limits set for study and had not received advice; they were randomised to control and treatment groups. INTERVENTIONS: Patients in treatment group were interviewed by general practitioner (who had had a training session) and received advice and information about how to reduce consumption and also given a drinking diary. END POINT: Study aimed at detecting a reduction in proportion of men with excessive alcohol consumption of 30% in treatment group and 20% in control group (for women 40% and 20%, respectively) with a power of 90% at 5% level of significance. In addition, corroborative measures such as estimation of gamma-glutamyltransferase activity were included. MEASUREMENTS AND MAIN RESULTS: At one year a mean reduction in consumption of alcohol of 18.2 (SE 1.5) U/week had occurred in treated men compared with a reduction of 8.1 (1.6) U/week in controls (p less than 0.001). The proportion of men with excessive consumption at interview had dropped by 43.7% in the treatment group compared with 25.5% in controls (p less than 0.001). A mean reduction in weekly consumption of 11.5 (1.6) U occurred in treated women compared with 6.3 (2.0) U in controls (p less than 0.05), with proportionate reductions of excessive drinkers in treatment and control groups of 47.7% and 29.2% respectively. Reduction in consumption increased significantly with number of general practitioner interventions. At one year the mean value for gamma-glutamyltransferase activity had dropped significantly more in treated men (-2.4 (0.9)IU/l) than in controls (+1.1(1.0)IU/l; t = 2.7, p less than 0.01). Reduction in gamma-glutamyltransferase activity tended to increase with number of intervention sessions in men. Changes in gamma-glutamyltransferase activity in women and changes in other indicators in both sexes did not differ significantly between treatment and control groups. CONCLUSIONS: If the results of this study were applied to the United Kingdom intervention by general practitioners could each year reduce to moderate levels the alcohol consumption of some 250000 men and 67500 women who currently drink to excess. General practitioners and other members of the primary health care team should therefore be encouraged to include counselling about alcohol consumption in their preventive activities.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.3M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Edwards G, Orford J, Egert S, Guthrie S, Hawker A, Hensman C, Mitcheson M, Oppenheimer E, Taylor C. Alcoholism: a controlled trial of "treatment" and "advice". J Stud Alcohol. 1977 May;38(5):1004–1031. [PubMed]
  • Babor TF, Ritson EB, Hodgson RJ. Alcohol-related problems in the primary health care setting: a review of early intervention strategies. Br J Addict. 1986 Feb;81(1):23–46. [PubMed]
  • Wallace PG, Haines AP. General practitioner and health promotion: what patients think. Br Med J (Clin Res Ed) 1984 Sep 1;289(6444):534–536. [PMC free article] [PubMed]
  • Russell MA, Wilson C, Taylor C, Baker CD. Effect of general practitioners' advice against smoking. Br Med J. 1979 Jul 28;2(6184):231–235. [PMC free article] [PubMed]
  • Jamrozik K, Vessey M, Fowler G, Wald N, Parker G, Van Vunakis H. Controlled trial of three different antismoking interventions in general practice. Br Med J (Clin Res Ed) 1984 May 19;288(6429):1499–1503. [PMC free article] [PubMed]
  • Russell MA, Stapleton JA, Jackson PH, Hajek P, Belcher M. District programme to reduce smoking: effect of clinic supported brief intervention by general practitioners. Br Med J (Clin Res Ed) 1987 Nov 14;295(6608):1240–1244. [PMC free article] [PubMed]
  • Anderson P, Cremona A, Wallace P. What are safe levels of alcohol consumption? Br Med J (Clin Res Ed) 1984 Dec 15;289(6459):1657–1658. [PMC free article] [PubMed]
  • Wallace P, Cremona A, Anderson P. Safe limits of drinking: general practitioners' views. Br Med J (Clin Res Ed) 1985 Jun 22;290(6485):1875–1876. [PMC free article] [PubMed]
  • Wallace PG, Brennan PJ, Haines AP. Are general practitioners doing enough to promote healthy lifestyle? Findings of the Medical Research Council's general practice research framework study on lifestyle and health. Br Med J (Clin Res Ed) 1987 Apr 11;294(6577):940–942. [PMC free article] [PubMed]
  • Wallace P, Haines A. Use of a questionnaire in general practice to increase the recognition of patients with excessive alcohol consumption. Br Med J (Clin Res Ed) 1985 Jun 29;290(6486):1949–1953. [PMC free article] [PubMed]
  • Mayfield D, McLeod G, Hall P. The CAGE questionnaire: validation of a new alcoholism screening instrument. Am J Psychiatry. 1974 Oct;131(10):1121–1123. [PubMed]
  • Wallace PG, Brennan PJ, Haines AP. Drinking patterns in general practice patients. J R Coll Gen Pract. 1987 Aug;37(301):354–357. [PMC free article] [PubMed]
  • Shaper AG, Pocock SJ, Ashby D, Walker M, Whitehead TP. Biochemical and haematological response to alcohol intake. Ann Clin Biochem. 1985 Jan;22(Pt 1):50–61. [PubMed]
  • Chick J, Kreitman N, Plant M. Mean cell volume and gamma-glutamyl-transpeptidase as markers of drinking in working men. Lancet. 1981 Jun 6;1(8232):1249–1251. [PubMed]
  • Haines AP, Booroff A, Goldenberg E, Morgan P, Singh M, Wallace P. Blood pressure, smoking, obesity and alcohol consumption in black and white patients in general practice. J Hum Hypertens. 1987 Jun;1(1):39–46. [PubMed]

Articles from The BMJ are provided here courtesy of BMJ Publishing Group