{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T06:54:53Z","timestamp":1770965693788,"version":"3.50.1"},"reference-count":26,"publisher":"BMJ","issue":"6649","license":[{"start":{"date-parts":[[1988,9,10]],"date-time":"1988-09-10T00:00:00Z","timestamp":589852800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1988,9,10]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bmj.297.6649.663","type":"journal-article","created":{"date-parts":[[2009,4,2]],"date-time":"2009-04-02T15:19:55Z","timestamp":1238685595000},"page":"663-668","source":"Crossref","is-referenced-by-count":471,"title":["Randomised controlled trial of general practitioner intervention in patients with excessive alcohol consumption."],"prefix":"10.1136","volume":"297","author":[{"given":"P.","family":"Wallace","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Cutler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Haines","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1988,9,10]]},"reference":[{"key":"ref_1","article-title":"Social trends. No 16","author":"Central Statistical Office","year":"1986","unstructured":"Central Statistical Office. Social trends. No 16. London: HMSO, 1986."},{"key":"ref_2","article-title":"A great and grotwing evil: the medical consequences of alcohol abuse","author":"of Physicians, Royal College","year":"1987","unstructured":"Royal College of Physicians. A great and grotwing evil: the medical consequences of alcohol abuse. London: Tavistock, 1987."},{"key":"ref_3","first-page":"1004","article-title":"Promoting better health: the government's programme for improving primary health care","volume":"4","author":"Edwards, G.; Orford, J.; Egert, S.","year":"1987","unstructured":"Department of Health and Social Security. Promoting better health: the government's programme for improving primary health care. London: HMSO, 1987. (CM 249.). 4 Edwards G, Orford J, Egert S, et al. 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Patients and their doctors, 1977. London: Royal College of General Practitioners, 1979. (Occasional paper No 8.) 8 Wallace P, Haines A. General practitioner and health promotion: what patients think. BrMedJ 1984;289:534-6."},{"key":"ref_6","first-page":"231","article-title":"Effect of general practitioners' advice against smoking. BrMedJ'","volume":"ii:","author":"Russell, M.A.H.; Wilson, C.; Taylor, C.; Baker, C.D.","year":"1979","unstructured":"Russell MAH, Wilson C, Taylor C, Baker CD. Effect of general practitioners' advice against smoking. BrMedJ' 1979;ii:231-5."},{"key":"ref_7","first-page":"1499","article-title":"Controlled trial of three different anti-smoking interventions in general practice","volume":"288","author":"Jamrozik, K.; Vessey, M.; Fowler, G.; Wald, N.; Parker, G.; Van Vinakis, H.","year":"1984","unstructured":"Jamrozik K, Vessey M, Fowler G, Wald N, Parker G, Van Vinakis H. Controlled trial of three different anti-smoking interventions in general practice. Br MedJ7 1984;288: 1499-1503."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1136\/bmj.295.6608.1240","article-title":"District programme to reduce smoking: effect of clinic supported brief intervention by general practitioners","volume":"295","author":"Russell, M.A.H.; Stapleton, J.A.; Jackson, P.H.; Hajek, P.; Belcher, M.","year":"1987","unstructured":"Russell MAH, 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 1987;295: 1240-4.","journal-title":"Br. Med_J"},{"key":"ref_9","first-page":"1657","article-title":"What are safe levels of alcohol consumption?","volume":"289","author":"Anderson, P.; Cremona, A.; Wallace, P.","year":"1984","unstructured":"Anderson P, Cremona A, Wallace P. What are safe levels of alcohol consumption? BrMed7 1984;289:1657-8.","journal-title":"BrMed7"},{"key":"ref_10","first-page":"1875","article-title":"Safe limits of drinking: general practitioners'","volume":"290","author":"Wallace, P.; Cremona, A.; Anderson, P.","year":"1985","unstructured":"Wallace P, Cremona A, Anderson P. Safe limits of drinking: general practitioners' views. BrMedJ 1985;290:1875-6.","journal-title":"views. BrMedJ"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1080\/09595238580000421","article-title":"Detection and management of patients with excessive alcohol consumption in general practice","volume":"4","author":"Haines, A.P.; Wallace, P.","year":"1985","unstructured":"Haines AP, Wallace P. Detection and management of patients with excessive alcohol consumption in general practice. 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Br Med J 1985;29: 1949-53.","journal-title":"Br Med J"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1176\/ajp.131.10.1121","article-title":"The CAGE questionnaire; validation of a new alcoholism screening instrument","volume":"131","author":"Mayfield, D.; McLeod, G.; Hall, P.","year":"1974","unstructured":"Mayfield D, McLeod G, Hall P. The CAGE questionnaire; validation of a new alcoholism screening instrument. AmJ Psychiatry 1974;131:1121-3.","journal-title":"AmJ Psychiatry"},{"key":"ref_15","first-page":"354","article-title":"Drinking patterns in general practice patients","volume":"37","author":"Wallace, P.G.; Brennan, P.; Haines, A.P.","year":"1987","unstructured":"Wallace PG, Brennan P, Haines AP. Drinking patterns in general practice patients. J R Coll Gen Pract 1987;37:354-7.","journal-title":"J R Coll Gen Pract"},{"key":"ref_16","article-title":"Assessing alcohol consumption in general practice patients-a comparison between questionnaire and interview","author":"Cutler, S.; Wallace, P.; Haines, A.P.","unstructured":"Cutler S, Wallace P, Haines AP. Assessing alcohol consumption in general practice patients-a comparison between questionnaire and interview. Alcohol Alcohol (in press).","journal-title":"Alcohol Alcohol"},{"key":"ref_17","article-title":"Beating heart disease","author":"Health Education Council","year":"1985","unstructured":"Health Education Council. Beating heart disease. London: HEC, 1985."},{"key":"ref_18","first-page":"89","article-title":"Alcohol dependence: methodological issues in its measurement; reliability of the criteria","volume":"78","author":"Chick, J.","year":"1983","unstructured":"Chick J. Alcohol dependence: methodological issues in its measurement; reliability of the criteria. BrJAddict 1983;78:89-95.","journal-title":"BrJAddict"},{"key":"ref_19","article-title":"Drinking in England and Wales: an enquiry on behalfofthe Department ofHealth and Social Security","author":"Wilson, P.","year":"1980","unstructured":"Wilson P. Drinking in England and Wales: an enquiry on behalfofthe Department ofHealth and Social Security. London: HMSO, 1980."},{"key":"ref_20","article-title":"That's the limit","author":"Council, Health Education","year":"1985","unstructured":"Health Education Council. That's the limit. London: HEC, 1985."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1177\/000456328502200104","article-title":"Biochemical and haematological responses to alcohol intake","volume":"22","author":"Shaper, A.G.; Pocock, S.J.; Ashby, D.; Walker, M.; Whitehead, T.P.","year":"1985","unstructured":"Shaper AG, Pocock SJ, Ashby D, Walker M, Whitehead TP. Biochemical and haematological responses to alcohol intake. 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