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3240598 
Journal Article 
Addressing alcohol problems in primary care: A cluster randomized, controlled trial of a systems intervention - The screening and intervention in primary care (SIP) study 
Saitz, R; Horton, NJ; Sullivan, LM; Moskowitz, MA; Samet, JH 
2003 
Yes 
Annals of Internal Medicine
ISSN: 0003-4819
EISSN: 1539-3704 
138 
5 
372-382 
WOS:000181257300002 
Background: screening and intervention for alcohol problems
can reduce drinking and its consequences but are often not implemented. Objective: To test
whether providing physicians with patients' alcohol screening results and simple individualized
recommendations would affect the likelihood of a physician's having a discussion with patients
about alcohol during a primary care visit and would affect subsequent alcohol use. Design:
Cluster randomized, controlled trial. Setting: Urban academic primary care practice.
Participants: 41 faculty and resident primary care physicians and 312 patients with hazardous
drinking. Interventions: Providing physicians with alcohol screening results (CAGE questionnaire
responses, alcohol consumption, and readiness to change) and recommendations for their patients
at a visit. Measurements: Patient self-report of discussions about alcohol use immediately after
the physician visit and alcohol use 6 months later. Results: Of 312 patients, 240 visited faculty
physicians, 301 (97%) completed the outcome assessment after the office visit, and 236 (76%) were
followed for 6 months. Faculty physicians in the intervention group tended to be more likely than
faculty physicians in the control group to give patients advice about drinking (adjusted
proportion, 64% [95% CI, 47% to 79%] vs. 42% [CI, 33% to 53%]) and to discuss problems associated
with alcohol use (74% [CI, 59% to 85%] vs. 51% [CI, 39% to 62%]). Resident physicians' advice
and discussions did not differ between groups. Six months later, patients who saw resident
physicians in the intervention group had fewer drinks per drinking day (adjusted mean number of
drinks, 3.8 [CI, 1.9 to 5.71 versus 11.6 [CI, 5.4 to 17.7]). Conclusions: Although effects seem
to differ by physician level of training, prompting physicians with alcohol screening results and
recommendations for action can modestly increase discussions about alcohol use and advice to
patients and may decrease alcohol consumption.