Elsevier, The Lancet, Volume 389, 14 January 2017
Background Although structured psychological treatments are recommended as first-line interventions for harmful drinking, only a small fraction of people globally receive these treatments because of poor access in routine primary care. We assessed the effectiveness and cost-effectiveness of Counselling for Alcohol Problems (CAP), a brief psychological treatment delivered by lay counsellors to patients with harmful drinking attending routine primary health-care settings. Methods In this randomised controlled trial, we recruited male harmful drinkers defined by an Alcohol Use Disorders Identification Test (AUDIT) score of 12–19 who were aged 18–65 years from ten primary health centres in Goa, India. We excluded patients who needed emergency medical treatment or inpatient admission, who were unable to communicate clearly, and who were intoxicated at the time of screening. Participants were randomly allocated (1:1) by trained health assistants based at the primary health centres to enhanced usual care (EUC) alone or EUC combined with CAP, in randomly sized blocks of four to six, stratified by primary health centre, and allocation was concealed with use of sequential numbered opaque envelopes. Physicians providing EUC and those assessing outcomes were masked. Primary outcomes were remission (AUDIT score of
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Keywords:
Adolescent; Adult; Adverse Effects; Aged; Alcohol Consumption; Alcohol Drinking; Alcoholism; Article; Clinical Effectiveness; Clinical Protocol; Clinical Protocols; Clinical Trial; Controlled Study; Cost Benefit Analysis; Cost Effectiveness Analysis; Cost Of Illness; Cost-benefit Analysis; Counseling; Counselor; Counselors; Disability; Drinking Behavior; Economics; Health Care Utilization; Health Center; Hospital Admission; Human; Humans; India; Major Clinical Study; Male; Middle Aged; Multicenter Study; Outcome Assessment; Partner Violence; Patient Counseling; Patient Health Questionnaire 9; Prevention And Control; Primary Health Care; Priority Journal; Procedures; Psychology; Psychotherapy; Quality Adjusted Life Year; Randomized Controlled Trial; Remission; Suicide Attempt; Treatment Outcome; Work Disability; Asia