The variability of outcomes used in efficacy and effectiveness trials of alcohol brief interventions: A systematic review

Gillian W Shorter, Jeremy W Bray, Emma L Giles, Amy O'Donnell, Anne H Berman, Aisha Holloway, Nick Heather, Carolina Barbosa, Kelly J Stockdale, Stephanie Scott, Mike Clarke, Dorothy Newbury-Birch

Research output: Contribution to journalLiterature reviewpeer-review

Abstract / Description of output

Objective: To characterize recent alcohol brief intervention (ABI) efficacy and effectiveness trials; summarize outcomes; and show how variability in outcomes and reporting compromises the evidence base.

Method: A systematic review and narrative synthesis of articles from 10 databases were undertaken (Jan 2000-Nov 2017); study selection represented recent, readily available publications. Alcohol brief intervention definitions were informed by National Institute of Clinical Excellence (NICE) Public Health Guideline 24: Alcohol use disorders: prevention. The review was conducted using Centre for Reviews and Dissemination (CRD) guidance and pre-registered on PROSPERO (CRD42016047185). Seven a priori specified domains were used to classify outcomes: biomarkers, alcohol related outcomes, economic factors/resource use, health measures, life impact, intervention factors, and psychological/behavioral factors.

Results: The search identified 405 trials from 401 eligible papers. In 405 trials, 2641 separate outcomes were measured in approximately 1560 different ways. The most common outcomes used were number of drinks consumed in a week and frequency of heavy episodic drinking. Biomarkers were least frequently used. The most common primary outcome was weekly drinks. By trial type, the most frequent outcome in efficacy and effectiveness trials was frequency of heavy drinking.

Conclusions: Consumption outcomes predominated; however, no single outcome was found in all trials. This comprehensive outcome map for ABI effectiveness and efficacy trials can aid decision making in future trials. There was diversity of instruments, time points, and outcome descriptions in methods and results sections. Compliance with reporting guidance would support data synthesis and improve trial quality. This review establishes need for a core outcome set/minimum data standard (COS) and supports the Outcome Reporting in Brief Interventions: Alcohol initiative (ORBITAL) to improve standards in the ABI field through a COS for effectiveness and efficacy randomized trials.
Original languageEnglish
Pages (from-to)286-298
JournalJournal of Studies on Alcohol and Drugs
Volume80
Issue number1
Early online date30 Jun 2019
DOIs
Publication statusE-pub ahead of print - 30 Jun 2019

Keywords / Materials (for Non-textual outputs)

  • alcohol drinking
  • alcohol brief intervention
  • randomized controlled trials
  • outcome assessment
  • core outcome set
  • systematic review

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