{
  "abstract": "Abstract Objective To evaluate the effectiveness of a doctor delivered screening and ultra-brief intervention (<1 minute) compared with simplified assessment only for reducing alcohol intake among patients with hazardous drinking in primary care.Design Pragmatic cluster randomised controlled trial.Setting 40 primary care clinics in Japan that did not provide routine screening and brief intervention for hazardous drinking or treatment or self-help groups for alcohol dependency.Participants 1133 outpatients aged 20-74 years with hazardous drinking (AUDIT-C (alcohol use disorders identification test-consumption) scores ≥5 for men and ≥4 for women). Clinic clusters were allocated to a study arm using a computer generated random sequence. Participants and staff who collected participant reported outcomes remained blinded to assignment.Interventions Primary care clinics were randomised to ultra-brief intervention (21 clinics, 531 patients) or simplified assessment only (19 clinics, 602 patients) groups. The intervention group comprised screening with AUDIT-C followed by brief oral advice and an alcohol information leaflet delivered in <1 minute. The control group comprised simplified assessment with AUDIT-C only.Main outcome measures The primary outcome was total alcohol consumption in the four weeks preceding the 24 week follow-up. Secondary outcomes included total alcohol consumption in the four weeks preceding the 12 week follow-up, and readiness to change drinking behaviour, measured at 12 and 24 weeks.Results At 24 weeks, the difference in total alcohol consumption between the ultra-brief intervention group (1046.9 g/4 weeks (g/4wk), 95% confidence interval (CI) 918.3 to 1175.4) and control group (1019.0 g/4wk, 893.5 to 1144.6) was 27.8 g/4wk (−149.7 to 205.4, P=0.75), with a Hedges’ g of 0.02 (95% CI −0.10 to 0.14). At 12 weeks, the difference in total alcohol consumption between the intervention group (1034.1 g/4wk, 919.6 to 1148.7) and control group (979.3 g/4wk, 866.1 to 1092.4) was 54.9 g/4wk (−104.1 to 213.9, P=0.49), with a Hedges’ g of 0.04 (−0.08 to 0.16).Conclusion This trial found no evidence to support the effectiveness of a doctor delivered ultra-brief intervention for hazardous drinking compared with simplified assessment only in primary care in Japan.Trial registration UMIN Clinical Trials Registry UMIN000051388.",
  "authors": [
    {
      "affiliations": [
        "CureApp, Tokyo, Japan",
        "Okayama Psychiatric Medical Centre, Okayama, Japan",
        "Department of Health Promotion of Human Behaviour, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan",
        "Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan"
      ],
      "name": "Ryuhei So"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Okayama City Hospital, Okayama, Japan"
      ],
      "name": "Kazuya Kariyama"
    },
    {
      "affiliations": [
        "Department of Biostatistics, JORTC Data Centre, Tokyo, Japan"
      ],
      "name": "Shunsuke Oyamada"
    },
    {
      "affiliations": [
        "National Hospital Organization, Kurihama Medical and Addiction Centre, Yokosuka, Kanagawa, Japan"
      ],
      "name": "Sachio Matsushita"
    },
    {
      "affiliations": [
        "CureApp, Tokyo, Japan",
        "Okayama Psychiatric Medical Centre, Okayama, Japan"
      ],
      "name": "Hiroki Nishimura"
    },
    {
      "affiliations": [
        "Addiction Treatment Centre, Department of Psychiatry, Okinawa Rehabilitation Centre Hospital, Okinawa, Japan"
      ],
      "name": "Yukio Tezuka"
    },
    {
      "affiliations": [
        "Saga Prefecture Medical Centre Koseikan, Saga, Japan"
      ],
      "name": "Takashi Sunami"
    },
    {
      "affiliations": [
        "Department of Health Promotion of Human Behaviour, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan"
      ],
      "name": "Toshi A Furukawa"
    },
    {
      "affiliations": [
        "Department of Health Promotion of Human Behaviour, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan",
        "Population Health and Policy Research Unit, Medical Education Centre, Kyoto University Graduate School of Medicine, Kyoto, Japan"
      ],
      "name": "Ethan Sahker"
    },
    {
      "affiliations": [
        "Kawaguchi Medical Clinic, Okayama, Japan"
      ],
      "name": "Mitsuhiko Kawaguchi"
    },
    {
      "affiliations": [
        "Department of Hepatology, Japanese Red Cross Okayama Hospital, Okayama, Japan"
      ],
      "name": "Haruhiko Kobashi"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Kawasaki Medical School, Okayama, Japan"
      ],
      "name": "Sohji Nishina"
    },
    {
      "affiliations": [
        "Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan"
      ],
      "name": "Yuki Otsuka"
    },
    {
      "affiliations": [
        "Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan"
      ],
      "name": "Hideyuki Kanda"
    },
    {
      "affiliations": [
        "Department of Health Promotion of Human Behaviour, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan",
        "Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan",
        "Oku Medical Clinic, Osaka, Japan"
      ],
      "name": "Yasushi Tsujimoto"
    },
    {
      "affiliations": [
        "Keiai Clinic, Tokyo, Japan"
      ],
      "name": "Yoshinori Horie"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Nara Medical University, Nara, Japan"
      ],
      "name": "Hitoshi Yoshiji"
    },
    {
      "affiliations": [
        "National Hospital Organization, Hizen Psychiatric Medical Centre, Saga, Japan",
        "Chikugo Yoshii Cocoro Hospital, Fukuoka, Japan"
      ],
      "name": "Takefumi Yuzuriha"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, Okayama City Hospital, Okayama, Japan"
      ],
      "name": "Kazuhiro Nouso"
    }
  ],
  "title": "Effectiveness of screening and ultra-brief intervention for hazardous drinking in primary care: pragmatic cluster randomised controlled trial",
  "uid": "e25a1b7a-c66b-5dd2-9a1e-24aa4f3ad3ab"
}