Volume 215 - Issue 11
Screening and brief interventions for harmful alcohol use: where to now?
Author: Chris B Holmwood
Med J Aust 2021; 215 (11): 526-526. || doi: 10.5694/mja2.51342
Published online: 13 December 2021
Published online: 13 December 2021
In reply
In reply: Malinovská and Brož’s1 description of the situation in the Czech Republic demonstrates just how difficult it can be to implement alcohol screening, brief intervention and referral for treatment (SBIRT), even with legislation compelling health professionals to provide the intervention. Lack of knowledge by clinicians is one barrier, along with hesitancy to raise the issue, for a range of different reasons. Education can assist with these two factors. Other barriers include time pressure and competing clinical priorities.2,3
Good quality evidence on the delivery of services in Australian primary care, including dealing with alcohol‐related presentations and SBIRT, has not been available since the cessation of the Bettering the Evaluation and Care of Health (BEACH)4 surveys in 2016; therefore, comparative data are not available in Australia.
Essentially, if SBIRT is contemplated on a systemic basis, additional resources must be allocated in addition to education. However, from the Scottish experience, even additional resources do not guarantee that there will be any effect on drinking on a population basis.5 There should be evidence‐based public health measures, mostly aimed at supply reduction, to bring about a significant reduction in drinking.
A recent review6 describes how measures such as taxation, limiting outlets and reducing advertising have resulted in impressive reductions in alcohol intake in those former Soviet Union countries where they have been implemented.
Competing interests
No relevant disclosures.
References
- Malinovská J, Brož J. Screening and brief interventions for harmful alcohol use: where to now? [Letter] Med J Aust 2021; 215: 000–000.
- Nilsen P, Aalto M, Bendtsen P, Seppä K. Effectiveness of strategies to implement brief alcohol intervention in primary healthcare. A systematic review. Scand J Prim Health Care 2006; 24: 5–15.
- Rosário F, Santos MI, Angus K, et al. Factors influencing the implementation of screening and brief interventions for alcohol use in primary care practices: a systematic review using the COM‐B system and Theoretical Domains Framework. Implement Sci 2021; 16: 6.
- University of Sydney. Bettering the Evaluation and Care of Health (BEACH). National Study of general practitioner clinical activity. https://www.sydney.edu.au/medicine‐health/our‐research/research‐centres/bettering‐the‐evaluation‐and‐care‐of‐health.html (viewed Apr 2021).
- Beeston C, McAdams R, Craig N, et al. Monitoring and evaluating Scotland’s Alcohol Strategy: final annual report. Edinburgh: NHS Health Scotland, 2016. http://www.healthscotland.scot/media/1100/mesas‐final‐annual‐report_5780_mar‐2016.pdf (viewed July 2020).
- Neufeld M, Bobrova A, Davletov K, et al. Alcohol control policies in former Soviet Union countries: A narrative review of three decades of policy changes and their apparent effects. Drug Alcohol Rev 2021; 40: 350–367.