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Download or read book The Physicians' Guide to Helping Patients with Alcohol Problems written by and published by . This book was released on 1995 with total page 22 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Zena Hyman
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (234 download)
Download or read book Brief Interventions for High-risk Drinkers in the Primary Care Setting written by Zena Hyman and published by . This book was released on 2007 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Aim: The aims of this pilot study were to (a) describe the extent to which primary care providers (PCP) at the Veterans Administration (VA) fully implement clinical practice guidelines (CPG) for VA primary care patients who fail their Audit C, (b) conduct a supplemental intervention to complete all elements of the CPG, and (c) estimate the extent to which the patient's drinking is reduced thereby. ... Conclusion: The VA CPG for risky drinking was not completely implemented in usual care. Pilot data suggested that a more complete intervention would benefit at least the heaviest drinkers, but replication with a larger sample size will be required. Key Words: Primary care, clinical practice guideline, high-risk drinking, alcohol, brief intervention, outcomes model, translation research."--Page iii.
Author : Antoni Gual
Publisher : Frontiers Media SA
ISBN 13 : 2889198871
Total Pages : 85 pages
Book Rating : 4.8/5 (891 download)
Download or read book Brief Interventions for Risky Drinkers written by Antoni Gual and published by Frontiers Media SA. This book was released on 2016-06-29 with total page 85 pages. Available in PDF, EPUB and Kindle. Book excerpt: Alcohol is the sixth leading risk factor for disability and premature death all over the world, and one of the leading causes of premature mortality in western societies; it is a leading risk factor for death in young and middle-age males. Heavy drinking accounts for about two thirds of the burden of disease attributable to alcohol. In the early 1980s, screening and brief interventions (SBI) in primary health care settings were proposed as effective strategies to identify risky drinkers and to help them reduce their drinking. Since then, a growing body of evidence, including several meta-analysis and Cochrane reviews, has shown the efficacy and effectiveness of SBI in primary health settings. However, demonstrating the effectiveness of SBI has not been insufficient to facilitate its general implementation in the routines of primary health care physicians, and in fact the dissemination of SBI has proven to be a difficult business. Qualitative and quantitative research has identified most of the facilitators and barriers for its implementation, and publicly funded research has been earmarked to address the dissemination problems worldwide. Some examples are the World Health Organization Phase III and Phase IV studies on the identification and management of alcohol-related problems in primary care, EU funded projects (PHEPA, AMPHORA, ODHIN, BISTAIRS), the UK SIPS trials and the SBIRT developments sponsored by the Substance Abuse & Mental Health Services Administration (SAMHSA) in the USA. The efficacy and effectiveness of SBI in primary health is now well established, but there are still some questions that remain unsolved: which practitioners should deliver them; what length should they be; is there a need for booster sessions; is there added value of a motivational approach? These questions, together with other relevant aspects of SBI, need ongoing research. In recent years, SBIs have been tested in settings other than primary health care, including hospitals, accident and emergency rooms, criminal justice, colleges and universities, social services and pharmacies. In some of those areas, the evidence is scarce (for example, pharmacies) while in others it is very promising (for example, students and hospitals). New technologies have also offered the possibility of online tools, and, in the last few years, different digital-based applications have been tested successfully as new ways to deliver effective SBIs to larger amounts of people. Brief interventions have also spread to drugs other than alcohol. This book aims to be an update of the state-of-the art of brief advice. It is a compilation of articles published by some of the most relevant researchers in the field in Frontiers in Psychiatry between 2014 and 2016.
Author : Ching-Han Helen Chan
Publisher : Open Dissertation Press
ISBN 13 : 9781361325094
Total Pages : pages
Book Rating : 4.3/5 (25 download)
Download or read book Physician and Nurse-Led Brief Intervention for Alcohol Drinking in the Primary Care Setting written by Ching-Han Helen Chan and published by Open Dissertation Press. This book was released on 2017-01-26 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dissertation, "Physician and Nurse-led Brief Intervention for Alcohol Drinking in the Primary Care Setting: a Systematic Review" by Ching-han, Helen, Chan, 陳靜嫻, was obtained from The University of Hong Kong (Pokfulam, Hong Kong) and is being sold pursuant to Creative Commons: Attribution 3.0 Hong Kong License. The content of this dissertation has not been altered in any way. We have altered the formatting in order to facilitate the ease of printing and reading of the dissertation. All rights not granted by the above license are retained by the author. Abstract: Background: With the increasing public health concern over the alcohol related health burden and mortality globally, the World Health Organization (WHO) has listed alcohol use as the top three risk factors in Non-Communicable Disease (NCD) and the alcohol related mortality and morbidity could be avoided through early intervention and prevention. The Department of Health (DH) of Hong Kong Special Administration Region (HKSAR) has declared the alcohol epidemic was alarming with the increasing in prevalence of alcohol use and binge drinking especially among young people with the westernization of Hong Kong society. In combating local alcohol use epidemic, DH has put priority to reform health care sector system and to ensure that the local health care system is responsive to the local alcohol use problem. Brief intervention (BI) was found to be effective in dealing with at-risk alcohol use especially in primary health care settings in the various past systematic reviews. However, most reviews mainly focus on physician-led BI while the role of nurse in BI delivery in alcohol drinking had not been under great attention. The effectiveness of nurse-led BI to at-risk drinking has not been fully examined as compared with physician-led interventions in the past reviews. Evaluation of treatment components in terms of intensity, treatment components and service settings may also shed light to public health policy makers in development of local model of BI in dealing with drinking problem in the Chinese population. Objective: To investigate the effectiveness of physician-led or nurse-led BI on quantity of alcohol consumption, number of drinking days, number of binge drinking episode and health care utilization. The potentially effective treatment intensity, treatments components and setting of intervention were also investigated. Methods: All the studies published from 1990 to 2012 in MEDLINE, would be evaluated on the effectiveness of BI delivered by physicians and/or nurses to adult at-risk drinkers in primary health care settings, were searched and identified using a combination of keywords. Results: A total of 13 randomized controlled trials out of 134 articles from MEDLINE were included in this systematic review. The included studies used different outcome measurements to compare the effectiveness of BI by physicians and/or nurses in treating at-risk drinking. Similar demographics and clinical characteristics of the subjects between the intervention and control groups were reported. The studies were from 5 countries. The age range of subjects was from 14 to 75 years old. Majority of subjects drank beyond the recommended limits defined by Alcohol Abuse and Alcoholism (NIAA), United State (US). Through there were discrepancies among the results generated in the included studies on the effectiveness of physician-led and/ or nurse-led BI, the benefits of nurse-led BI in treatment of at-risk drinking cannot be dispelled and could be considered as an alternative or supplement to the physician-led BI in busy primary health care setting today. BI with at least two 5-15 minute sessions was found to be more effective than very BI with one 5-minute session only. High quality BI with all five essential treatment components (information giving, advice, goal setting, assistance and follow up) were found to be more effective than partially i
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309089352
Total Pages : 761 pages
Book Rating : 4.3/5 (9 download)
Download or read book Reducing Underage Drinking written by Institute of Medicine and published by National Academies Press. This book was released on 2004-03-26 with total page 761 pages. Available in PDF, EPUB and Kindle. Book excerpt: Alcohol use by young people is extremely dangerous - both to themselves and society at large. Underage alcohol use is associated with traffic fatalities, violence, unsafe sex, suicide, educational failure, and other problem behaviors that diminish the prospects of future success, as well as health risks â€" and the earlier teens start drinking, the greater the danger. Despite these serious concerns, the media continues to make drinking look attractive to youth, and it remains possible and even easy for teenagers to get access to alcohol. Why is this dangerous behavior so pervasive? What can be done to prevent it? What will work and who is responsible for making sure it happens? Reducing Underage Drinking addresses these questions and proposes a new way to combat underage alcohol use. It explores the ways in which may different individuals and groups contribute to the problem and how they can be enlisted to prevent it. Reducing Underage Drinking will serve as both a game plan and a call to arms for anyone with an investment in youth health and safety.
Author : Paolo Boffetta
Publisher : Oxford University Press
ISBN 13 : 0199655782
Total Pages : 445 pages
Book Rating : 4.1/5 (996 download)
Download or read book Alcohol written by Paolo Boffetta and published by Oxford University Press. This book was released on 2013-03-07 with total page 445 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by international leaders in the field of alcoholism, this book provides an interdisciplinary source of information on alcoholism that links together science, policy, and public health in order to emphasise the importance of scientific knowledge with deciding public health policy.
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309040388
Total Pages : 640 pages
Book Rating : 4.3/5 (9 download)
Download or read book Broadening the Base of Treatment for Alcohol Problems written by Institute of Medicine and published by National Academies Press. This book was released on 1990-02-01 with total page 640 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this congressionally mandated study, an expert committee of the Institute of Medicine takes a close look at where treatment for people with alcohol problems seems to be headed, and provides its best advice on how to get there. Careful consideration is given to how the creative growth of treatment can best be encouraged while keeping costs within reasonable limits. Particular attention is devoted to the importance of developing therapeutic approaches that are sensitive to the special needs of the many diverse groups represented among those who have developed problems related to their use of "man's oldest friend and oldest enemy." This book is the most comprehensive examination of alcohol treatment to date.
Author : Rebecca Samad
Publisher :
ISBN 13 :
Total Pages : 22 pages
Book Rating : 4.:/5 (123 download)
Download or read book Alcohol Use Screening and Brief Intervention in Primary Care Settings written by Rebecca Samad and published by . This book was released on 2019 with total page 22 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this study was to collect and evaluate the literature on alcohol use screening and brief intervention in primary care settings. Systematic searches were conducted using six databases (PsycINFO, Google Scholar, Google, MEDLINE, CSUN Oviatt Library, and CINAHL). Alcohol use screening instruments CAGE, MAST, and AUDIT were researched. Each has advantages and disadvantages, which limits the versatility of any individual screening test in its applicability to a variety of situations and populations. Further research is necessary to develop tests that are more inclusive of detecting all levels of alcohol use risk, while are also not complicated for primary care practitioners to use. Future steps are required to improve the consistency in screening for alcohol misuse in primary care settings, and subsequently applying brief interventions for populations of low-to-medium risk levels.
Author : Peter Anderson
Publisher : WHO Regional Office Europe
ISBN 13 : 9789289013284
Total Pages : 104 pages
Book Rating : 4.0/5 (132 download)
Download or read book Alcohol and Primary Health Care written by Peter Anderson and published by WHO Regional Office Europe. This book was released on 1996 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book goes some way to answering the questions of how the harm done by alcohol use can be prevented and managed in primary health care. It discusses strategies and approaches that can be adopted by primary health care providers in their everyday work with individuals and families, and outlines the possibilities for them to participate in community action and to advocate for healthy public policy on alcohol.
Author : Mats Berglund
Publisher : John Wiley & Sons
ISBN 13 : 9783527306824
Total Pages : 660 pages
Book Rating : 4.3/5 (68 download)
Download or read book Treating Alcohol and Drug Abuse written by Mats Berglund and published by John Wiley & Sons. This book was released on 2003 with total page 660 pages. Available in PDF, EPUB and Kindle. Book excerpt: Programs for treating substance abuse should be built on a foundation of evidence-based knowledge. This guide presents the findings from more than 1,600 studies on the effectiveness of different treatments.
Author :
Publisher :
ISBN 13 :
Total Pages : 234 pages
Book Rating : 4.:/5 (831 download)
Download or read book Brief Interventions and Brief Therapies for Substance Abuse written by and published by . This book was released on 2012 with total page 234 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author :
Publisher :
ISBN 13 :
Total Pages : 0 pages
Book Rating : 4.:/5 (136 download)
Download or read book Brief Interventions for Risky Drinkers written by and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Alcohol is the sixth leading risk factor for disability and premature death all over the world, and one of the leading causes of premature mortality in western societies; it is a leading risk factor for death in young and middle-age males. Heavy drinking accounts for about two thirds of the burden of disease attributable to alcohol. In the early 1980s, screening and brief interventions (SBI) in primary health care settings were proposed as effective strategies to identify risky drinkers and to help them reduce their drinking. Since then, a growing body of evidence, including several meta-analysis and Cochrane reviews, has shown the efficacy and effectiveness of SBI in primary health settings. However, demonstrating the effectiveness of SBI has not been insufficient to facilitate its general implementation in the routines of primary health care physicians, and in fact the dissemination of SBI has proven to be a difficult business. Qualitative and quantitative research has identified most of the facilitators and barriers for its implementation, and publicly funded research has been earmarked to address the dissemination problems worldwide. Some examples are the World Health Organization Phase III and Phase IV studies on the identification and management of alcohol-related problems in primary care, EU funded projects (PHEPA, AMPHORA, ODHIN, BISTAIRS), the UK SIPS trials and the SBIRT developments sponsored by the Substance Abuse & Mental Health Services Administration (SAMHSA) in the USA. The efficacy and effectiveness of SBI in primary health is now well established, but there are still some questions that remain unsolved: which practitioners should deliver them; what length should they be; is there a need for booster sessions; is there added value of a motivational approach? These questions, together with other relevant aspects of SBI, need ongoing research. In recent years, SBIs have been tested in settings other than primary health care, including hospitals, accident and emergency rooms, criminal justice, colleges and universities, social services and pharmacies. In some of those areas, the evidence is scarce (for example, pharmacies) while in others it is very promising (for example, students and hospitals). New technologies have also offered the possibility of online tools, and, in the last few years, different digital-based applications have been tested successfully as new ways to deliver effective SBIs to larger amounts of people. Brief interventions have also spread to drugs other than alcohol. This book aims to be an update of the state-of-the art of brief advice. It is a compilation of articles published by some of the most relevant researchers in the field in Frontiers in Psychiatry between 2014 and 2016.
Author :
Publisher :
ISBN 13 :
Total Pages : 548 pages
Book Rating : 4.3/5 (91 download)
Download or read book Special Report to the U.S. Congress on Alcohol & Health written by and published by . This book was released on 1993 with total page 548 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Author : Institute of Medicine
Publisher : National Academies Press
ISBN 13 : 0309133661
Total Pages : 528 pages
Book Rating : 4.3/5 (91 download)
Download or read book Improving the Quality of Health Care for Mental and Substance-Use Conditions written by Institute of Medicine and published by National Academies Press. This book was released on 2006-03-29 with total page 528 pages. Available in PDF, EPUB and Kindle. Book excerpt: Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
Author : Eleanor J. Sullivan
Publisher :
ISBN 13 :
Total Pages : 194 pages
Book Rating : 4.:/5 (319 download)
Download or read book A Guide to Substance Abuse Services for Primary Care Clinicians written by Eleanor J. Sullivan and published by . This book was released on 1997 with total page 194 pages. Available in PDF, EPUB and Kindle. Book excerpt: EXECUTIVE SUMMARY AND RECOMMENDATIONS: The goal of this TIP is to recommend guidelines for primary care clinicians to follow in caring for patients with alcohol and other drug use disorders. These guidelines were developed by a Consensus Panel of clinicians, researchers, and educators who work on the prevention and treatment of substance use disorders. Protocols are based partly on research evidence, partly on Panel members' clinical experience. The algorithm to the left follows a patient with substance use problems who presents in a primary care setting. The chart will serve as a guide or road map through screening, brief assessment, brief intervention, assessment, referral, specialized treatment, and followup care as they are detailed in the TIP. Since substance use disorders are often chronic conditions that progress slowly over time, primary care clinicians, through their regular, long-term contact with patients, are in an ideal position to screen for alcohol and drug problems and monitor each patient's status. Futhermore, studies have found that primary care clinicians can actually help many patients decrease alcohol consumption and its harmful consequences through office-based interventions that take only 10 to 15 minutes (Kahan et al., 1995; Wallace et al., 1988). This potential, however, is largely untapped: Saitz and colleagues found that of a sample of patients seeking substance abuse treatment, 45 percent reported that their primary care physician was unaware of their substance abuse (Saitz et al., in press). Yet even though screening and limited treatment of substance use disorders do not require a large time investment, the Consensus Panel that developed this TIP recognized that many primary care clinicians are already overwhelmed by the demands imposed by expanded gatekeeper functions. The Panel realized that a practical approach to addressing patients' substance abuse problems was needed: one that recognized the time and resource limitations inherent in primary care practice and offered a series of graduates approaches that could be incorporated into a normal clinic or office routine. Biological, medical, and genetic factors as well as psychological, social, familial, cultural, and other environmental features all bear on substance abuse. Addressing the condition effectively requires a team effort, especially when it has progressed beyond the early stage. For this reason, in addition to screening and intervention treatment options, these guidelines include information about viable referral for assessment and treatment, as well as followup. Readers will notice that the TIP contains more information on alcohol use and abuse than on use of illicit drugs. This reflects both the scope of the problems and the research literature available about them. It is estimated that about 18 million people with alcohol use problems and 5 million users of illicit drugs need treatment. Although the Panel recognizes that tobacco is an addictive substance with a major public health impact, it is not included in this TIP because the topic falls outside CSAT's purview. Readers are referred to "Smoking Cessation: a Guide for Primary Care Clinicians," published by the Agency for Health Care Policy and Research (Agency for Health Care Policy and Research, 1996). The Consensus Panel's recommendations are based on a combination of clinical experience and research-based evidence. In the list below, the summary guidelines supported by the research literature are followed by (1); clinically based recommendations are marked (2). Citations supporting the former are referenced in the body of the document. Screening and assessment instruments mentioned below are reproduced and discussed in Chapters 2 and 4 and Appendix C. The guidelines are presented in more detail in Chapter 6.
Author : Paul S. Haber
Publisher : Specialty of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney
ISBN 13 : 1742104894
Total Pages : 408 pages
Book Rating : 4.7/5 (421 download)
Download or read book Guidelines for the Treatment of Alcohol Problems written by Paul S. Haber and published by Specialty of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney. This book was released on 2021-04-01 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Australian Guidelines for the Treatment of Alcohol Problems have been periodically developed over the past 25 years. In 1993, the first version of these guidelines, titled: ‘An outline for the management of alcohol problems: Quality assurance in the treatment of drug dependence project’ was published (Mattick & Jarvis 1993). The Australian Government commissioned an update a decade later (Shand et al. 2003) and a further edition in 2009 to integrate the Guidelines with the Australian Guidelines to Reduce Health Risks from Drinking Alcohol (National Health and Medical Research Council, NHMRC 2009; Haber et al., 2009). The present version of the Guidelines was also commissioned by the Commonwealth of Australia to remain current and integrated with the updated NHMRC consumption guidelines (2020). In order to ensure that guidelines remain relevant, the next set of guidelines should be updated in 2025, consistent with NHMRC recommendation that guidelines be updated every five years. These guidelines aim to provide up-to-date, evidence-based information to clinicians on available treatments for people with alcohol problems and are largely directed towards individual clinicians in practice, such as primary care physicians (general practitioners, nursing staff), specialist medical practitioners, psychologists and other counsellors, and other health professionals. Some chapters highlight service or system level issues that impact on clinicians and their patients. These include recommendations concerning Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse groups, stigma, and discrimination. Elsewhere, organisation capacity is implied, such as medical resources for withdrawal management where recommendations indicate use of medications. As all forms of treatment will not be readily available or suitable for all populations or settings, these guidelines may require interpretation and adaptation.
Author : Evelyn P. Whitlock
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (869 download)
Download or read book Behavioral Counseling Interventions in Primary Care to Reduce Risky/harmful Alcohol Use written by Evelyn P. Whitlock and published by . This book was released on 2004 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: CONTEXT: Excessive alcohol consumption increases risks for numerous chronic diseases, injuries, disabilities, mortality, and for a host of social and interpersonal problems. Many drinkers who do not meet diagnostic criteria for alcohol use disorders nonetheless consume alcohol at levels or in patterns that increase the risks of negative health and social consequences. Primary health care visits offer opportunities to identify and briefly intervene with these drinkers to reduce their consumption below at-risk levels and patterns. OBJECTIVE: To systematically review evidence for the efficacy of brief behavioral counseling interventions conducted in primary care settings to reduce risky/harmful alcohol consumption or patterns, and to link this evidence to results from other systematic reviews of alcohol screening in primary care populations. DATA SOURCES: We searched the Cochrane Database of Systematic Reviews and Database of Research Effectiveness (DARE) (2001, issues 2 and 3; 2002 issue 1), using an inclusive search strategy (alcohol* or drink*) to identify recent, high-quality, English-language systematic reviews of primary care interventions to reduce risky/harmful alcohol use. We searched MEDLINE, Cochrane Controlled Clinical Trials, PsychInfo, HealthSTAR, and CINAHL databases from 1994 through April 2002, using a similarly inclusive search strategy. We also retrieved all recent systematic reviews of screening for alcohol disorders in primary care and all relevant screening and intervention literature reviewed in the 1996 Guide to Clinical Preventive Services or included in other systematic reviews of brief alcohol interventions for risky/harmful use. STUDY SELECTION: We identified 12 controlled alcohol intervention trials conducted with general adult patients, 3 with pregnant women, and 1 with adolescents that took place in primary care settings and were of good or fair internal validity according to US Preventive Services Task Force (USPSTF) criteria. DATA EXTRACTION: Data elements were abstracted on standardized forms and included information about the setting, study design, participant inclusion and exclusion criteria, randomization process (if applicable), size and composition of study groups, intervention components (rationale, behavioral techniques, length and number of sessions, provider), follow-up period(s), loss to followup, and alcohol consumption and other outcomes. DATA SYNTHESIS: Good evidence supports the efficacy of brief, multi-contact primary care interventions for risky/harmful alcohol use in primary care patients identified through screening and screening-related assessment of at-risk drinking and alcohol use disorders. Patients in these trials underwent screening to identify those possibly in need of alcohol misuse intervention in primary care or elsewhere, followed by screening-related clinical assessment to qualify patients appropriate for primary care-based intervention or for referral to specialty treatment of abuse/dependence. Patients were screened generally using standardized self-report instruments alone (e.g., AUDIT), or in combination, (e.g., CAGE with standardized quantity and frequency questions) that have been found to be valid in primary care populations. After primary care brief, multi-contact interventions, patients reduced average drinks per week by 13%-34% and increased the proportion drinking at moderate or safe levels by 10%-19% compared with controls. Similar population-level reductions in average alcohol consumption have been projected to reduce the prevalence of alcohol abuse/dependence by 3%, while use of alcohol within safe/recommended levels has been epidemiologically related to reduced short-term (e.g., injuries, alcohol-related problems) and long-term (e.g., cirrhosis, total mortality) health risks. CONCLUSIONS: Brief, multi-contact behavioral counseling interventions among adult primary care patients are feasible and potentially highly effective components of an overall public health approach to reducing alcohol misuse. Future research should focus on developing implementation strategies that facilitate the adoption of these practices as a regular part of routine health care. Additional research is needed to develop effective interventions among sub-populations such as pregnant women, ethnic minorities, and adolescents.
